Healthcare fraud

Wednesday, July 19, 2006

Everyone has a right to an opinion, although…

As the surgeon General has demonstrated his once quite credible office, is now an excellent source of speculation and political opinion, recently severed from the burdens of integrity or that more cumbersome burden of protecting public health. The SG in his finest hour demonstrates examples of social engineering even Sadam would be proud of. A self appointed referee who seeks to end the petty squabbles of the discovery process in his recent decree “we already know all we need to know”.

The CDC will now be transformed as the international clearing house and numero uno supplier of low quality but acceptable statistical facts and the international benchmark of acceptable medical belief. Some interpretations of the presentations made could generously be described as merely controversial as enthusiastic overstatements however some are no less than outright lies; none the less the General has spoken; ”the debate is now over”.

It all began with the demonstrated ability of healthcare professionals global power in redefining property rights shown in the redefinition of the term “public spaces”. Then moving into domination of environment and emission standards, in asserting new non linear associations to replace complicated cause and effect principles. Eliminating previous belief in the effect of poison is in the dose as now an outdated theory. We now we move to replacing the word correlation with cause. In declaring the mystery of SIDS is in our past and although science and medicine does not support it; severe asthma has also been given a specific cause. The win-win situation will allay all swimming pool off gas theories. Accusations made by wrong headed individuals for decades, which were coming dangerously close to public liability which could of course would involve compensation. We don’t want to see another messy agent orange or gulf syndrome episode on our hands after all.

Smoking is the cause of all evil in mortality and morbidity with that said, the savings in wasted research dollars can be better used enforcing the power of democracy around the globe.
“because I say so” will soon be printed on all American currency to establish healthcare as supreme rule in globalist democracy with the recently integrated socialist reforms. Healthcare is not finished yet, a lot of work needs to be done. Abortion and assisted suicide were successful in establishing the beach head. The cloning of human embryos is almost within our grasp. This will soon lead to a full term clone. After establishing the civil rights of that future clone; we will establish a moral authority to replace the recently departed aunt Martha, and alleviate the health concerns associated with the sadness in her passing. Soon all petty superstitious values can be set aside, affording all charity be directed to its rightful place to the auspices of deserving permanent medical charities. The soldiers who have fought long and hard to supplant the new reality of global dominance in respect of the deserving and superior components of the human gene pool.

Churches and the old moral values of the dinosaurs are soon to be replaced permanently with the tailoring of the term miracle of creation to more closely align with clinical realities. Church doctorates were inconsistent in allowing the drinking of wine the eating of living creatures and smoking of a peace pipe. Darwin can be our only true savior. We don’t live in silos was the rallying cry to end discontent in severance of rights to nationalist self determination. The authority of the UN is now accepted as supreme rule in all law above the petty laws of member states. How much more efficient will this world be for the right headed, when we live in miniaturized silos, now carelessly defined as test tubes which will can one day replace the definition and use of the retro terms; womb and parent.

Lets deal with the present situation, in a more immediate reality shall we?
I have made every effort to demonstrate my arguments in use of sources solely deemed in the opinions of healthcare stakeholders, in dispensing only so called right headed evidence. Tobacco Control has been successful in solidifying the interests of the Tobacco industry the recent surgeon generals report stands as proof of that reality. Tobacco Control has been successfully subrogated as an asset of tobacco company interests and increased profitability.

It would now be no longer necessary to expend vast fortunes in the defense of OJ Simpson type legal defense. Once the legal profession catches on, the undermining of forensic evidence will be reduced to a matter of process within reach of a moderately trained Para-legal or legal assistant. This could lead to the retrying of many criminal cases with the once quite credible evidence of science now seen to be reduced to political consensus opinion.

Page 4 of the SG’ handout displays a number of poison gases as the reason to fear the deadly Tobacco smoke. He incredibly lists the most common sources of every one of those named poisons and proof of their existence in ambient air a forgotten component in the second hand smoke promotions. Their has to be somewhat of a credibility concern in declaring more non linear danger exists in trace amounts measured in cigarette smoke at almost undetectable levels with little concern for the major sources of those same contaminants. Unfortunately his wisdom ends at the business end of what ever it is he or silent Bob prefers to smoke, and of course he would never inhale.

Here is a selection of choice pronouncements from the Grand Pubbah of Quackdum County

■ There is no safe amount of secondhand smoke. Breathing even a little secondhand smoke can be dangerous.

■ Breathing secondhand smoke is a known cause of sudden infant death syndrome (SIDS). Children are also more likely to have lung problems, ear infections, and severe asthma from being around smoke.

Secondhand smoke causes heart disease and lung cancer.

Separate “no smoking” sections DO NOT protect you from secondhand smoke. Neither does filtering the air or opening a window

Did you know for instance although ETS is an unacceptable risk dangerous in all levels of exposures it only caries half the cancer risk of living in racially divided neighborhoods

“Multivariate modeling showed that, after controlling for tract-level SES measures, increasing segregation amplified the cancer risks associated with ambient air toxics for all racial groups combined [highly segregated areas: relative cancer risk (RCR) = 1.04; 95% confidence interval (CI), 1.01–107; extremely segregated areas: RCR = 1.32; 95% CI, 1.28–1.36]. …Results suggest that disparities associated with ambient air toxics are affected by segregation and that these exposures may have health significance for populations across racial lines.”

This is an example of a .32 increased risk to see the really scary and quite significant numbers we have to look at urban centers individually where disparities can be more focused in observation non urban and areas of varying cultural diversity can tend to lower the outcomes. Here is a study of Maryland the significance of the numbers can tell you a lot in how easy it is to make grand and quite misleading statements in pointing at smoking when they know smoking is much more prevalent in lower socioeconomic sectors poverty is much more significantly associated to cancers and a host of other mortality and morbidity figures, which as economic inspired risks, coexist with cigarettes in disproportionately much larger but parallel numbers in all health risk categories.

The idea of higher taxation to lower mortality and morbidity, can be shown to be having a devastating effect in tremendous mortality and morbidity increases. This doesn’t even consider the corresponding increased violence consistent with increased poverty, which is the real pandemic we should be dealing with.

These are really scary cancer risk numbers much more decisive and credible than anything coming out of Tobacco control.

Census tracts in the highest quartile defined by the fraction of African-American residents were three times more likely to be high risk (> 90th percentile of risk) than those in the lowest quartile (95% confidence interval, 2.0–5.0). Conversely, risk decreased as the proportion of whites increased (p <>. Census tracts in the lowest quartile of socioeconomic position, as measured by various indicators, were 10–100 times more likely to be high risk than those in the highest quartile. We observed substantial risk disparities for on-road, area, and nonroad sources by socioeconomic measure and on-road and area sources by race. There was considerably less evidence of risk disparities from major source emissions. We found a statistically significant interaction between race and income, suggesting a stronger relationship between race and risk at lower incomes.

Consider the CPS11 study for perspective.

. Lung cancer death rates, adjusted for other factors, were 20 percent higher among women whose husbands ever smoked during the current marriage than among those married to never-smokers (relative risk [RR] = 1.2, 95 percent confidence interval [CI] = 0.8-1.6). For never-smoking men whose wives smoked, the RR was 1.1 (CI = 0.6-1.8). Risk among women was similar or higher when the husband continued to smoke (RR = 1.2, CI = 0.8-1.8), or smoked 40 or more cigarettes per day (RR = 1.9, CI = 1.0-3.6), but did not increase with years of marriage to a smoker.

Most CIs included the null. Although generally not statistically significant, these results agree with the EPA summary estimate that spousal smoking increases lung cancer risk by about 20 percent in never-smoking women. Even large prospective studies have limited statistical power to measure precisely the risk from ETS.

The SG also failed to mention in assessing indoor to outdoor air risk and total exposures when smoking is not a factor indoor air presents 3 times the cancer risk as outdoor air. Simply working indoors presents a much higher risk than ETS measured indoors or out.

Some of the personal measured exposures are interesting to note. The EPA and CDC can be shown the errors in their ways, in assessing and portraying to the public the ETS soup as a whole, devoid of measurements of the known ingredients or expressed as individual levels actually existing. The term “ETS causes 3000 cancer deaths annually” in a 320 million population this would represent in a 1 excess death per million standard 9.375 per million in comparison in evaluation of air toxics the air soup containing 10s of thousands of potentially toxic ingredients only 168 were determined worthy of monitoring by the EPA. The results of measurements showed a number of ETS ingredients when measured alone in non smoking environments were proven in many instances to be much more toxic than the total of ETS assessments.

This is the most significant and compelling of all the facts presented here;

The right to health relevant information derives from the principles of autonomy and self direction and has been recognized in international declarations. Providing accurate health information is part of the basis for obtaining “informed consent” and is a recognized component of business ethics, safety communications, and case and product liability law.”

More research can be found here

although the content is legitimate I fully expect the self serving critique of the healthcare lobby as unacceptable regardless of content or the origin of the links posted.

If anyone wants to offer an alternate opinion please feel free to comment.

My opinions are based in continuing research and of content which I have studied in depth. I have changed opinions many times in the process on a number of issues, changes were made based in discovering more credible research and it’s investigation.

In direct comparison all units of one excess cancer risk per 1 million population.

ETS 9.375 lifetime risk [Calculated above]
From personal monitoring of exposures; 3 days in primarily non smoking indoor environments, measured excess risk assessments

Benzene 133

Carbon 31.3

Tetrachloride Chloroform 801

Ethyl benzene 13.4

Methylene chloride 6.39

MTBE 41.4

Styrene 5.25

Perc 135

No safe cigarette? Hides the knowledge some cigarettes are much safer than others. By as much as 97% reduced carcinogenic risk. The scary part is the CDC has known for years manufacturers can alter the carcinogenic content substantially, yet took no steps to reduce those risks, allowing unnecessary increased carcinogen exposures to continue, while claiming to protect the public??? In many countries including Canada the risk was substantially increased by lowering trade barriers allowing the Tobacco Industry to use cheaper much more dangerous products. The Ontario Government all but destroyed the source of safer domestic products and allowed their own tobacco growers to be all but eliminated without debate. The government sings their own praises as protectors of the right, enforced in a threat to smokers “Quit or be punished” from the Health ministry, the supreme rulers of newly claimed public spaces, is this the punishment phase, a return to capitol punishment and a bypassing of the courts?

As proof; research of the physical variety, which should be more convincing than the calculations of biased political opinions.

Tobacco-specific nitrosamines (TSNAs) comprise one of the major classes of carcinogenic compounds in mainstream cigarette smoke.

From Brazil

In only one country, Brazil, were the carcinogenic TSNA levels in mainstream smoke from Marlboro cigarettes significantly lower than in the locally popular brand. However, carcinogenic TSNA levels in mainstream smoke from Brazilian Marlboro cigarettes were usually lower than those in mainstream smoke from the Marlboros purchased in the other 13 countries, suggesting a reason for the difference. The wide range of mainstream smoke carcinogenic TSNA levels measured in the present study (8.7-312 ng/cigarette) suggest that manufacturers can lower the carcinogenic TSNA levels and that, for similar filter ventilation, carcinogenic TSNA levels in the tobacco filler of a cigarette are a useful indicator of the corresponding levels in mainstream smoke.

Need more proof testing of 170 commercial brands throughout Europe and north America 15 years ago along with a multitude of research since found in the associated articles link.

Both primary as well as secondary smoke would have a tremendous increased risk as a result, affecting all of community. This makes the recent announcements by the surgeon general kind of self fulfilling prophesy which he admits to the harm he caused in callous depraved indifference unbefitting his office.

From the peanut gallery, the much acclaimed and much quoted sergeant pea brain himself;

James Repace likes to discuss Particulate matter and polycyclic aromatic hydrocarbons PPAH sounds like scary stuff, in fact the known safe level is .2 Milligrams or 200 micrograms. As far as polycyclic aromatic hydrocarbons are concerned no real risk is present in his averaged levels found in the bars and casinos he tested. He made paid announcements for the Robert Wood Johnson Foundation declaring indoor air he tested had much higher concentrations of toxins. Dispelling the truth in where the higher volume toxins actually existed; diluted in vastly larger volumes of outdoor air, despite his preparations. If the air outdoors was as high as indoor concentrations, with or without tobacco smoke we would already be extinct. He likes to hide the volume of dilatants and how they may affect the levels of toxins he uses in his scary story promotions of childish rhetoric, selling his credentials and integrity to the highest bidder

Hookers are honest in their presentations of what they do for a buck, no one doubts who they really are, Repace? A kindred associate still hiding in the closet.

He was once paid to establish a known safe level

today he sing the praises from the no safe level hymnbook.

PPAH is assumed by Repace to be a component of all respiratory particulate matter in cigarette smoke in a proportion .08% for calculation 205 Micrograms particulate measured times .0008 = 164 Nanograms

In a smoking allowed Casino the average smoke measurements were 205 Mg/m3{RSPs} and .08% =

163 Ng/m3 {PPAH}before a ban and 9Mg/m3{RSPs} and 4Ng/m3{PPAH} after a ban

Reality Bites Repace on his lying backside; safe level 200 micrograms measured level 0.164 micrograms

He contends this is 10,000 times the known safe level, requiring hurricanes to evacuate it from the bar???

The Occupational Safety and Health Administration (OSHA) has set a limit of 0.2 milligrams of PAHs per cubic meter of air (0.2 mg/m³).

The reality in upsetting the calculated applecart is in the real science of observation.

When air pollution in a city declines, the city benefits with a directly proportional drop in death rates, a new study has found. For each decrease of 1 microgram of soot per cubic meter of air, death rates from cardiovascular disease, respiratory illness and lung cancer decrease by 3 percent -- extending the lives of 75,000 people a year in the United States. The association held even after controlling for smoking and body-mass index Particulate air pollution consists of a mixture of liquid and solid particles, mostly a result of fossil fuel combustion and high-temperature industrial processes. By definition, the particles have a diameter less than 2.5 microns, or about one ten-thousandth of an inch.

"For the most part, pollution levels are lower in this country than they were in the '70s and '80s," said Francine Laden, the study's lead author, "and the message here is that if you continue to decrease them, you will save more lives."

Further declines in air pollution are within reach, said Laden, an assistant professor of environmental epidemiology at Harvard. "The technology is out there," she said. "The cities that we've covered have cleaned up considerably."

Laden said the study supported what the federal scientific advisers had advocated: tightening the air quality standard below the present 15 micrograms per cubic meter.

"There was discussion about lowering it to 12," she said, "and this study supports that."

Here is a real shocker which would he ban first, a pack of cigarettes or a Truck?


WASHINGTON, DC, July 12, 2001 (ENS) - Exhaust from diesel engines accounts for 78 percent of the total added cancer risk in outdoor air from all hazardous air pollutants combined, shows a new analysis of U.S. Environmental Protection Agency (EPA) data.

The analysis by the conservation group Environmental Defense is based on a massive EPA study, which provides detailed estimates of the levels of 41 top hazardous air pollutants in every community in the U.S. EPA's previous version of the air pollutant report did not include information on diesel particulate emissions.

"The dominance of diesel in the unhealthiness of our air is a revelation," said David Roe, Environmental Defense senior attorney. "It couldn't be seen before, only because studies weren't trying to look for it."


Sunday, July 16, 2006

Ethics cleansing

I would like to take this opportunity to advise all interested parties; in my opinion the CDC, The World Health Organization the Surgeon General of the United states, along with the throngs of stakeholders involved in stealing public funds to distribute the lies are all murderers and guilty of international coercive activities detrimental to the public good causing thousands of unnecessary deaths and disease in their misleading promotions. Planned depraved indifference, in categorized health groups dispensing illegal acts of social cleansing.

As the surgeon General pointed out tobacco smoke is not safe in any quantity or exposure level he failed to mention, it could be much safer if he did his job competently, as described in protecting the health of the public, all of the public.

As proof I offer you research of the physical variety, which should be more convincing than the calculations of biased political opinions.

Tobacco-specific nitrosamines (TSNAs) comprise one of the major classes of carcinogenic compounds in mainstream cigarette smoke.

From Brazil

In only one country, Brazil, were the carcinogenic TSNA levels in mainstream smoke from Marlboro cigarettes significantly lower than in the locally popular brand. However, carcinogenic TSNA levels in mainstream smoke from Brazilian Marlboro cigarettes were usually lower than those in mainstream smoke from the Marlboros purchased in the other 13 countries, suggesting a reason for the difference. The wide range of mainstream smoke carcinogenic TSNA levels measured in the present study (8.7-312 ng/cigarette) suggest that manufacturers can lower the carcinogenic TSNA levels and that, for similar filter ventilation, carcinogenic TSNA levels in the tobacco filler of a cigarette are a useful indicator of the corresponding levels in mainstream smoke.

First, the World health organization in conjunction with the CDC in examining Winston brand cigarettes sold in 14 different countries found a huge differential in carcinogenic toxins in the products tested, yet took no actions although they knew the manufacturers could alter the ingredients to make the products 97% carcinogen reduced. Nor did they advise the public of crucial information which could substantially impact public health.. What did they do? The surgeon General made public statements advising the public there is no safe cigarette purposefully leading the public to believe at the same time there were no safer cigarettes which the Surgeon Generals office knew existed and failed to disclose. The international rights of the population who smoke as well as those concerned for their health as a result of second hand smoke exposure, are being violated in cold and clinical depraved indifference..

This is a fact known as early as 1989-1990 when comparative testing was done of 170 brands in the USA and Europe and replicated in a multitude of similar tests done since. All seem to agree the quantity of NNN and NNK pre-existing is although significantly dependant on Nitrate levels, Carcinogens were found to be much higher in local North American brands. Those amounts could be changed if the will was expressed. It was apparently not important enough to protect a population group comprising 25% of the total population in order to sell smoking patches and promote unnecessary smoking bans having no impact overall; in public health or reduced mortality risk. in dispensing false and misleading propaganda in a deceit of the general population.

The so called denormalizing of an industry has been seen to be completely focused on a punishment of consumers based on what is said to be an addiction. Tobacco industries earn more profits in a reduced sales environment with such efforts as tobacco settlements being passed along with huge taxation to those same consumers leaving the Tobacco industry unharmed in those actions. The no safe cigarette song is gladly repeated by tobacco industry spokesmen in opening of trade barriers to cheaper more toxic products. In undermining national growing and curing regulations specific to countries in which their products are sold. Executives of big tobacco who know; belief and acceptance of no safe cigarette would remove all product regulation responsibilities from them. If there is no safe cigarette, there is of course no motivation to make them safer and no penalty could ever be imposed and enforced for dispensing more harmful products or in punishing the potential harm they may cause. They could now include anthrax if they found an advantage in it’s use, and remain within the confines of legal business practices and above the scrutiny of the public..

The Tobacco industry last year attempted to launch a toxin reduced product which was met with a huge opposition from groups such as ASH who tell the public in essence the concept is not possible or would it be beneficial, speaking volumes as to the motivations of ASH. Dismissing huge potential in reduced toxic effect as useless, despite the fact science tells us otherwise. ASH also aims to have smokers restricted from gaining employment, Housing and even access to one’s own children. In viewing the WHO research which showed no increased risk to children who live with smoking parents, a lot of urban legends seem to be emulating from this well financed lobby.

The reality is the mortalities we see today are a result of smoking in the 60s in the majority if everyone quit smoking today they would still be tabulating smoking related diseases in the year 2060 reductions in toxins in product regulation can have a huge impact on those mortalities within weeks or months. If the health promotions are legitimately to reduce mortalities aggressive steps should be underway to regulate the product and not to punishing it’s victims.

From the conclusions;

The results demonstrated that there is no correlation between TSNA and tar deliveries in mainstream smoke. The TSNA deliveries in mainstream smoke depend on the amount or preformed TSNA in the actual tobacco composition, which is influenced by the nitrate level of the tobacco and the tobacco type. According to these results the tar delivery, although crucial, is not a sufficient index for the biological activity and the carcinogenic potential of cigarette smoke. Reduction of TSNA exposure can be achieved by selecting tobaccos with low levels of preformed TSNA in tobacco, which means a low nitrate content and reduction of the amount of Burley tobaccos and stems in blended cigarettes.

The lies of so called health care professionals are easily found for instance, in the 50% of smokers they claim will die of their habit, a lie. Anyone with a calculator who takes the population base of Canada in 1960 54% smokers or 8.1 million in keeping with the CSP11 and SAMMEC research we find over 90% of the 50% who will die in the smoking related disease categories, in a 30 year time span between 50 and 80 years of age. If we take half of the total smokers and divide by 30 we should see a number of total mortalities who die of smoking related diseases 90% of that figure would tell you the number who should die this year of smoking related mortality

Check my math I came up with 135,000 total and 121,500 annually over 50, within the 30 year time frame ending in 14 years time. A long way from the 44,000 + 3000 ETS mortalities claimed. Almost 3 times as many. We would consider the one sixth of smokers number demonstrated as a time line observation in the perspective of using the numbers of actual mortalities given. We must consider the number to be even at that fraction, to be grossly exaggerated as; the more than 90% who do not die as a result of smoking, many do actually die in those same smoking related disease categories as well, although the numbers are clearly not well known or distributed.

This can be directly associated to the level of enthusiasm within a determined self serving group, in one lie feeding another until the story is without reasonable proportion. Now consider, of those who did die of smoking related diseases, had they been using carcinogen reduced tobacco how many lives of the initial 8.1 million could have been saved?

There is good reason for stakeholders to want to place the blame for cost and mortality on the consumer, in the incompetent regulation of a dangerous product. The huge tax grabs made possible in slandering a significant portion of the population while allowing thousands to die unnecessarily hardly sets a tone for confidence in government process. How long and hard did people have to fight for agent orange or gulf syndrome settlements? or in Canada for compensation of tainted blood victims? how hard will the same governments fight to keep this planned slaughter under wraps?

From the Canadian studies of products sold;

Twenty-five brands of Canadian commercial cigarettes were analyzed for tobacco-specific nitrosamines (TSNA) in tobacco and in mainstream smoke as well as for nitrate in tobacco. Preformed N'-nitrosonor-nicotine (NNN) in the tobacco ranged from 265 ng to 979 ng/cigarette, preformed 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) ranged from 465 ng to 878 ng/cigarette. The mainstream smoke concentration for NNN was between 5 ng and 39 ng/cigarette and for NNK between 5 ng and 97 Ng/cigarette. The nitrate levels were between 0.3 mg and 3.4 mg/cigarette. The NNK levels in tobacco and in mainstream smoke were higher than the NNN levels, which is typical for Virginia-type cigarettes. Based upon the average mainstream smoke concentration of the three most popular Canadian cigarette brands, an average TSNA delivery for 20 cigarettes of 0.7 micrograms NNN and 1.7 micrograms NNK can be calculated, which is less than the average for West German cigarettes.

Informed consent is the ability to make a free will choice determined by all relevant information being disclosed. Governments have failed in their duty to respect those rights and have in planned consensus with co conspirators withheld vital information for decades essential to health choices made by smokers in the use of a dangerous products which it appears those products were a lot more dangerous than they ever needed to be. Clearly there were choices to be made without information provided, choices based in toxin content could have determined manufactured changes through supply and demand in the absence of required regulation. That information was deliberately withheld in order to maintain tax levels and legitimize huge expenditures building networks of health care advocates to further control and tax innocent consumers through hate and slander in ad agency and media group purchases

Dispensing advice of no safe cigarette as easily dismissed as no safe water or air in respect to there is no safe anything, tells the public nothing. Telling the public there are safer cigarettes would have afforded choice In the information, by disclosing what is in a cigarette when contents changed, as they did many times. Decisions of product use could have been made prior to the time self inflicted harm occurred. The Government in Canada exaggerated the problem in mandating without disclosure of ingredients and potential risk, so called fire safe cigarettes. This in absence of clear disclosures toxic effect, amounts to human experimentation without informed consent. Illegal and deliberately deceptive in purchasing ad agency promotional materials to dispel any fears without truly knowing the level of harm those products could inflict. Certainly no smoker in the general public was ever clearly informed.

The Federal Government was elected in campaign promises to rebuild trust between the electorate and their chosen government officials. This is seen to be without merit when any citizen can go to the Health Canada website and see for themselves a process called social engineering; planned deceptions in ad agency spin to undermine the right of free will. The moralizing an ability to lie and deceive the public in purchased promotions similar to those employed and described in the Gomery Commission as sponsorships, which by the scale in comparison likely if true to form, stole much larger portions of Tax dollars.

There is little confidence in knowing the Canadian government receives information from the same American government lying their own people in order to suit the needs of competing industrial interests and increasing popularity in use of increased taxes to fill under funded community needs.

Those same cessation industries operate in Canada as well. By scale resulting mortalities in Canada are only 10% of those created in the States, however the numbers are still significant and inexcusable in international covenants regarding an apparent cull of smokers, who as the stakeholders state “refuse to quit”. In Ontario we heard shortly after the announcement of a planned smoking ban from the same health ministry a threat to smokers; “Quit or be punished” we now understand the full gravity of those threats against over 2 million citizens who live in Ontario and continue to smoke.

What's in Philip Morris International brands in Brazil?

What does the Canadian government monitor?

Hardly what you would call transparent, although six months ago even this information was held private and out of public view, while smoking continued by those who could have used it, in selecting safer brands.

I do not know of any source of Government information describing a quite different product sold in the States, distributed similarly, or at all in the public realm, which could be supplied readily by the American Government if demanded.

Saturday, July 15, 2006

What a tragic waste of resources

Smoking bans are a moralist imposition, the ideas shared in paternalist arguments such as "smoking is a trigger for asthmatics" fails the test of choice, when any asthmatic could make a choice easily based on a warning sign on the door whether or not to enter a place with a sign describing the conditions. Nut allergies warnings seem to be working. Informed consent is based on information provided. Jews were not dragged into the ovens, they walked in based on the coercion of their captors. They were similarly the victims of medical experimentation due to coercion of not only themselves but coercion of the public in protecting the health of the German people. At the same time distributing lies and half truths to sell their arguments.

We learned many lessons and produced international Laws based in those atrocities.
Many do not wish to discuss the parallels here, yet your discomfort in the discussion is proof in itself of your personal denial of the fact; the smoking bans and fat pandemic nonsense all part and parcel of a huge health movement, precisely in ignorance of those lessons learned in the past, the reason the Jewish people declared “Never again” The reason the rest of the world moved away from Eugenics in protections of the gene pool by eliminating unwanted components of it.

The healthcare professionals today would look at the Aryan brotherhood with disgust yet how similar the ethical values are based would make them closer in political opinion than the health community would ever admit. If we imagined the other group afforded the resources of the health community how loudly they would protest of civil liberties infringements in what they would do to them. Yet they currently would seem to be amused in the impositions promoted against primarily, the largest portion of the lowest socioeconomic sector of our population those who have no power or voice, with which to defend themselves while punishing an addiction how sane is that? A denormalization of an industry or a dozen seems to always include a plan of punishment of the victims as opposed to dealing with the products in constructive plans to make the products safer or eliminating them, in real protections of others, not in the hate and coercive activities currently employed and imposed on others.

Moralists have a tendency to be the drama queens who believe they have a right to make decisions for others instead of encouraging others to do well, in leading by example.

The examples they are taught to offer are those extreme circumstances carefully selected from world events, to hold high in demanding political interventions. No matter how remote and how far from the norm that example might be. Who is the biggest victim gets the biggest piece of the public trough. In reality few moralists have any respect for moral values at all, they simply use the moral arguments to demand power, based in the values of others who seek to live by those moral values of respect for each other. Moralists simply use morality as a club to beat free will into a subservient slave to promote a single will. If the argument is weak, simply inject the effects on children to avoid realistic debate, to hide behind them as other terrorists do in using civilians as shields.

The self descriptions of stakeholders; right headed or politically correct are the standards set, although few in the moralist crowd understand who is creating the rules or do they care enough to look. They would all adamantly acclaim they are the leaders of what is right and all others are subversive or unworthy of opinion.

Moralist think themselves above the respect of debate with the unenlightened, when such fine plans have already been decided. Attacking the character of others is much more comfortable than actually engaging in productive debate. Including others in decisions already paid for and underway would only confuse the issues. Issues decided primarily not even in discussions among themselves but described in orchestrated cheering crowd convention rallies and given them from a podium speech.

The language the arguments and the activities requiring participation all handed them by the few corporate moralists who understand what healthcare professionals need to do in order to serve others. It seems comical when participating in one of these pep rallies how much can be stuffed down thousands of peoples throats, without complaint more importantly without discussion or decision. They are inspired yet soul searching would quickly reveal, they, in the majority do not know why. Or more important how.

The grass is always greener mentalities convinces moralists the best seats are taken by smokers or the best clubs do not cater to them when in fact a club success is determined by the clients much more decisively than a management who should be free to make their choices in hospitality, it is a business of serving clients. Public spaces laws allow politicians to make choices in the management of privately owned bars they have never seen or do they have any capacity to understand client needs other than creative research handed them by the moralists who by forcing their bottoms into the seats they desire soon realize the atmosphere with reduced inclusions is not as desirable as it once appeared to be.

There is no choice for a smoker when even the right to sit under an outdoor umbrella is taken. A self employed person in Ontario with no other employees can be charged for smoking in their owned vehicle. Pulled over on a highway emitting megatons of toxins far in excess of all the toxins produced in cigarette smoke in history in one day. A roof overhang 50 feet over your head eliminates a patio from allowing smoking the smoke hazard with 5000 indescribable ingredients, most not described because the volumes are below the levels of detection, smoke diluted in huge volumes of air, with tens of thousands of chemical pollutants in volumes detected easily and known to be above safe levels. Regardless of the reality with smokers banned, the patio may sit empty because the non smokers can not stand the smell of traffic a sidewalk away from their meal.

Are we dong society a benefit in deciding free will, or have we started down a path we will learn to regret as moralists move to the top in deciding what is right for all of us in our micromanaged lives.

Next time you have the opportunity to speak to someone from a nation you would believe to be oppressed, ask them how they like the freedom we are all so proud of. In most cases you will hear it is a beautiful place but it is puzzling anyone could live under such oppressive government control with no rebellion of the people. Personally I can remember the sixties the freedom and standard of living well above what we are told we “enjoy” today. In comparison I feel sorry for the kids today who have all the choices made for them it seems, with no respect for their ability to think for themselves. In reality a teen has much advantage in comparison to some of the damaged minds endemic in older years who believe they are superior, despite the damage life inflicts on us all. Damaged primarily in immunities grown over decades witnessing the horrific things people do to each other.

Moralists, sold on their own superiority; are always looking over their shoulders because there will always be someone younger and brighter who will eventually take over the reins, perhaps someone more extreme and more willing to do what others would not dare. The competition of the extremists is necessary in holding onto the reins allowing even those who know better, to participate in those activities, in fear of those who will follow.

If that younger person is taught in moralist ways how extreme will they be? if, as moralists tend to forget, no respect is taught that child in the basics of free will, respect for others rights to make their own choices, and the tragedies which always follow, when those principles are not respected

Monday, July 10, 2006

The truth, the whole truth...?

Anti smoker advocacy relies heavily on the lack of knowledge in the general public and in many cases knowledge not existing in the public domain. Bill Gates once stated whom ever controls the information will control the world. It is quite easy to take a snippet of information not widely known in the public, to create half truths precipitating fears, which can be used advantageously in political campaigns.. This appears to be the case in many of the most popular battle cries of anti smokers in public tirades and feigned concerned citizens letters to the editor, attempting to illicit a public following while supplanting fictitious urban legends.

The RWJF tutelage of lobbies in the use of children to provoke maternal instincts and promote larger support. The further actions of RWJF in adjusting SAMMEC research to include child and baby mortalities statistically linked to smoking. This can be dissected in realizing the majority of the babies named are victims of SIDS which despite the promotions remains a syndrome or medical mystery of which smoking is only one of dozens of suspected causes. The public is not aware of the fact RWJF who receives the bulk of their funding from Johnson and Johnson and in fact RWJF is heavily invested in J&J stock. J&J are a competing interest nicotine delivery products charity begins at home has it’s limits. Consumers pay a disproportionate share of taxation because of the ability to avoid taxes, in charitable contributions.

I don’t see any feeding of children in Africa here, but a feeding of corporate profits. Half truths seen in the definition of the word charity foundation is a misconception of the public. In paying higher personal income taxes who would have guessed you could be increasing profits of the same suppliers of services, gouging us at the other end of the operation by charging for smoking patches perhaps 100s of times the cost of manufacture, while increasing our tax burden in cigarette taxation as the alternative.

When we hear about someone dying of lung cancer immediately the mind wanders to how that person was affected by tobacco was this a smoker or simply another victim of the smoke. The idea of socioeconomic linkages to smoking in knowing the lowest educated and lowest incomes are the groups more likely to start smoking has a lot of weight in who will eventually die of lung cancers which in all honesty can not be seen to be associated the effects of smoking to any degree close to the location where these people live. Lung Cancers are also more prevalent in urban areas than rural settings a fact which if the motivation were present could reveal a lot in assessing the true environment of a lung cancer patient.

In the year 2000 a breakdown of all cause mortality from the CDC showed Lung Cancers to derive less than 1% of total mortality in the same year SAMMEC research in Canada demonstrated a prevalence of 6% meaning either lung Cancer is six times more prevalent in the smaller Canadian population, or one of the sources of numbers can be seen to be highly flawed. Not to point fingers but, the CDC divestments are representative of death certificates and simply a relaying of the totals with no apparent gain. SAMMEC was designed to estimate the costs of smoking for financially advantageous use, in promotions of higher taxes and assessing damages in case it is ever needed in litigation.

The EPA defined the term Tobacco smoke as a single substance yet in reality many types of tobacco are harvested which are combined with a number of ingredients many of which the government is responsible themselves. In Canada new regulations regarding fire safe cigarette paper introduced a new array of chemical ingredients with no knowledge of what harm that may cause. Unknown to Canadian smokers potentially deadly human biological testing is being done as we speak, without their knowledge or consent.

Tobacco has always enjoyed a similar exclusion of international law evident in the array of ingredients which have been adjusted for decades without notice. Trade secrets rights have been stretched beyond the greater public good with the aid of incompetent governments and inadequacies in the courts.

In 1970 testing was done on 170 common cigarette brands the results should have evoked an immediate advocacy response, if, of course the end game were truly connected to the health and welfare of others, not simply serving self important needs. The research clearly showed in spectral analysis a variance of carcinogenic and potential chronic disease effects which could be reduced by more than 98% by simply regulating what is being smoked. If a product is unsafe why is the effort focuses on the users while ignoring the much more efficient method of reducing mortality, by reducing the potential harm in the product.

ASH revealed their cards when responding to Tobacco company claims to have produced a safer cigarette in loudly dismissing the possibility out of hand. A sign of ignorance beyond acceptable behavior, promoting the status quo and the higher levels of dangers to maintain a political prominence position which would be reduced if the product was safer. Read the report yourself of the carcinogens which could be reduced by eliminating stocks and roots and selecting lower TSNA tobacco types A 98% reduction is not something to be take lightly.

Arch Geschwulstforsch. 1990;60(3):169-77.

Tobacco-specific nitrosamines in European and USA cigarettes.

“Institute for Toxicology and Chemotherapy, German Cancer Research Center, Heidelberg, FRG.

More than 170 types of commercial cigarettes from several European countries and the USA were analyzed for tobacco-specific nitrosamines (TSNA) in tobacco and mainstream smoke as well as for nitrate in tobacco. The cigarettes included filter and nonfilter cigarettes with different tar and nicotine yields. The observed range for N'-nitrosonornicotine (NNN) was from 4 to 1353 ng/cigarette in mainstream smoke and from 45 to 12454 ng/cigarette in tobacco. For 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) the values were between not detected (less than 4 ng/cigarette) and 1749 ng/cigarette in mainstream smoke and between not detected (less than 50 ng/cigarette) and 10745 ng/cigarette in tobacco. Nitrate levels ranged from 0.6 to 19.4 mg/cigarette. The TSNA levels for the cigarettes from the different countries investigated were in a similar range with the exception of few individual brands. The results demonstrated that there is no correlation between TSNA and tar deliveries in mainstream smoke. The TSNA deliveries in mainstream smoke depend on the amount or preformed TSNA in the actual tobacco composition, which is influenced by the nitrate level of the tobacco and the tobacco type. According to these results the tar delivery, although crucial, is not a sufficient index for the biological activity and the carcinogenic potential of cigarette smoke. Reduction of TSNA exposure can be achieved by selecting tobaccos with low levels of preformed TSNA in tobacco, which means a low nitrate content and reduction of the amount of Burley tobaccos and stems in blended cigarettes.”

See all Related Articles... I like to call these “a growing body of evidence” where have we heard that before? In anti smoker technology; a term used In reference to repetitive and cherry picked statistical proof undermining the type of proof you can actually see and consistently reproduce.

The parrots will all scream the figures of annual mortality in “smoking kills x people every year”. “Smoking bans are aimed at reducing x preventable deaths every year” Smoking bans of course do not address the problem outside of making a smoker’s life more difficult in hopes of forcing a will upon them they would not accept of their own free will, we have descriptors for those actions as well. “Preventable death” which in reality is a reflection of actions of smoking habits in the past which were never preventable deaths unless something was done in the past to reduce them.

If you are interested in reduced mortality in the future a 98% reduction in harm would tend to suit those ends with simple regulations and not promote a need to attack your neighbors for their choice to use; so far a legal product.

The battle cry promotions of “4=5000 deadly chemicals” and “a chemical soup” If queried the parroting is not associated with any secretive knowledge of what those chemicals may be, none of the criers know the list of chemicals or where to find such a list. In most cases the origin of the list statement is unknown, to even the most well known lobbies and their hired help. This deprives the public of that list, to determine if the composition represents a risk; included in every ingredient, or if we are simply being made to believe every chemical is deadly. The chemical soup avoids the fact spectral analysis can remove all mystery from their presentations in analyzing the soup. This is a complicated process which continues today after decades of improvements to the equipment and the processes. In analysis every compound tested would also create a large number of blips on the screen simply counting them is no indication of harm. Most ingested products would have similar ingredients quantities in reality there are tens of thousands of toxic chemicals in use today which common sense would tell you and measurements have confirmed all end up in the larger chemical soup we call air. Would it be going beyond the low level of ethical concern of anti smoker technology to make a statement; “With every inhalation of tobacco smoke you inhale 10s of thousands of deadly chemicals” a tune I am sure would be used, if one of them thought of it. The claim would be accurate but only reveal half of the truth.

Investigations would reveal Tobacco smoke as deadly as it is described can not hold a candle to the toxic nature or abilities of the major chemical soup inhaled along with the tobacco smoke, with every breath extending to every breath you take regardless of tobacco smoke. It is a hypocritical approach as seen in the Aspen model in establishing safe levels of 168 air toxics, the same EPA can evaluate a much more ingredient rich soup known as air and tell us what is safe to inhale yet can evaluate tobacco smoke as a soup with 50 known, monitored and adjustable toxics as beyond the reach of analysis or regulation. Hypocritical and non scientific as demonstrated in the vast array of physical ingredients and horticultural varieties being wide brushed in a definition as tobacco. Reinforced with a “there is no safe cigarette” an announcement which undermines the fact “there are safer cigarettes” as demonstrated by evaluation of their physical contents. Politics as opposed to scientific integrity in a government agency the public believes to be representing the latter, this can be seen as more potentially toxic than any cigarette could ever be. In evaluation failing the test of autonomy and free will.

The cry “fat is the new tobacco” should wake a few intelligent minds to the reality; this never was about cause nearly as much as control. Control is not limited to the targeted population groups but demanded of participating stakeholders..

Perhaps the largess of misconceptions in the statement “ventilation can not protect the public from the toxins found in tobacco smoke” as a premises for implementation of smoking bans. In a half truth, this conceals as proven in a number of research studies including most anti smokers favorite quoted passages; neither can ventilation protect us from a long list of other just as deadly toxins prevalent in indoor air many times in tremendously higher volumes.

Here is another research paper which reveals exposure to indoor toxins does not define the total exposure which is assumed to be cumulative if the public spends a majority of their time indoors a much larger hazard exists in indoor toxins overlooked as acceptable risk by the EPA who sets the standards for testing.

If anyone should be banned from public spaces to maximize protections of those concerned with preserving their health it should be the concerned who should be banned because the banning of cigarette smoke may improve the situation the one in a million standard is far from achieved the other 168 toxins monitored by the EPA are not found to be within safe levels, but much higher than acceptable levels beyond the risk of tobacco smoke in the case of benzenes and other toxins in the indoor environments we seek to regulate with the no safe level standard. Of one in a million excess mortality.

Personal exposure meets risk assessment: a comparison of measured and modeled exposures and risks in an urban community.

Devon C Payne-Sturges, Thomas A Burke, Patrick Breysse, Marie Diener-West, and Timothy J Buckley

Department of Environmental Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.

“Human exposure research has consistently shown that, for most volatile organic compounds (VOCs), personal exposures are vastly different from outdoor air concentrations. Therefore, risk estimates based on ambient measurements may over- or underestimate risk, leading to ineffective or inefficient management strategies”

The EPA can be shown the errors in their ways, in assessing and portraying to the public the ETS soup as a whole, devoid if measurements of the known ingredients or expressed as individual levels actually existing. The term “ETS causes 3000 deaths annually” in a 320 million population this would represent in a 1 excess death in a million standard 9.375 per million in comparison in evaluation of air toxics the air soup containing 10s of thousands of ingredients 168 were determined worthy of monitoring the results of measurements showed a number of ETS ingredients when measured alone in non smoking environments were proven to be much more toxic than the total of ETS assessments.

In direct comparison all units of excess cancer risk per 1 million. From personal monitoring

ETS 9.375 [Calculated above]

Benzene 133

Carbon 31.3

Tetrachloride Chloroform 801

Ethyl benzene 13.4

Methylene chloride 6.39

MTBE 41.4

Styrene 5.25

Perc 135

TC or at least the members dedicated to principled science and integrity, needs to start to realize anti smoker advocacy is not a part of Tobacco Control in supporting ethical value. Although they have raised the awareness of smoking hazards to an incredible degree, it was to serve self important interests enlisting the medical community proxy to say what ever it takes to arrive at that goal, profiting by the reputations of those enlisted. It may be a more useful position to encourage medical information depositories such as Pub Med or the BMJ to classify documents as political or scientific based primarily in evaluations of research conclusions, which often do not support the research presented more predominantly than the personal opinions being expressed in advocacy or personal political roles.

Big tobacco sponsored the tail end of research not fitting advocacy roles, a major research study the 35 year Kabat California report, this research can be dismissed as rhetoric due only to the credibility of the financiers with little scientific perusal of what was offered and appropriate critique, dismissed in a political argument alone. Alternately other less involved micro research with earth shaking conclusions in levels of heart disease decreases due to a smoking ban conclusions not seen historically or supported in physical science. Defined as questionable conclusions limited by duration and size yet the research can be given more prominence in the eyes of the Surgeon General in advising; smokers are now seen as a deviant subclass who should be avoided at all costs. Political opinion abounds as we saw in the Helena study, a war of personalities, totally unbecoming of medical professionals. Can we deem other industry sponsored research in a higher standard. Credibility awarded depending on the ability to purchase media spin. In self assessment of credibility and purchased perceptions as good corporate citizens; can the J&J corporation because they call themselves “the family company” be excused for advising parents to clean children’s toys or pollute indoor environments with toxic substances? Believed simply because of a corporate brand they purchased, which would portray them as less devious than tobacco company executives. and deserving of less scrutiny.

Sunday, March 26, 2006

Heresy in the ETS debate?

For evaluation and analysis, anyone like to comment?

The spin-doctors will have to work overtime to clean up the latest mess.

Is there any wonder the EPA is ignoring them?

The American Lung association has provided new evidence, which would suggest previous research concluding ETS to be a deadly carcinogen and a major health risk were largely flawed. When taken into consideration the low and inconclusive results of many major epidemiology papers the new information should prove those associations to be overstated or unfounded. Recent submissions should prove consistently the existence of ETS likely inconsequential other than an irritant in indoor air, as common sense would dictate.

Recent submissions stating another highly significant co-founder is likely three times as high as previously believed. This allows in a re-examination of previous research, if indeed the research were believed to be credible, allowances would have to have been made for a constant exposure in ambient air. A co-founder in previous research, which should indicate constant exposure as opposed to incidental exposure when in contact with ETS, could not possibly be inconsequentially in the results of the calculations. Inhalation exposures to outdoor air as a major component of indoor air cannot be simply dismissed if no analysis was done to differentiate the two. A description of the health effects largely identical to those described consistently in the effects of ETS leave cause for major concern.

As we know from previous research, the value of ventilation is inconsequential in respect to indoor air RSP or the PPAH produced known to be .08% of the former. In short the common belief would be designated smoking rooms, do not offer protection from a hazard ETS is believed to have a safe level of 16.3 picograms per cubic meter of air. Supporting statements, no safe level exists. Are we all doomed or is there cause for hope in reassessing the known facts? These facts as confirmed in research widely accepted in court and Government submissions globally, as shown by one of the more popular lobbyists here. et al Repace 1999 Brook v. Burswood Casino. In a submission August 7 2005 Critical Evaluation of Lincoln Scott’s Burswood Casino Air Quality.

If as the American Lung Association contends Outdoor air is three times as consequential in health risk. The expectation would have to be other risks were largely overstated. With the overwhelming agreement as demonstrated by a ratio of 8 to 1 As explained on the ALA website a ratio of those speaking in favor of lowering the limits of particulate matter substantially. Perhaps the global panic largely created by similar proposals promoting smoking bans can be seen as crying wolf, in the absence of other explanations to the contrary. Additionally the 8 to 1 ratio as described could be observed as a proof, in quality as opposed to quantity as a more reliable guide. HIA Health Interventions as abdicated by the Industry financed Lobby group also known, as The World health Organization, may be highly effective in control of decision-making processes. The process is impressive on the surface until you realize what they failed to disclose. The increased embarrassment potential when a theory is found to be wrong or in conflict with another is greatly increased. Theoretic calculations presented as fact have limits, as there are only so many deaths to go around. Public knowledge created in advocacy is much more wide spread because of HIA and a huge danger is present to credibility of process and all those involved Stakeholders. As in gold rush mentality in get rich quick schemes, they rarely pan out.

The many potential components and many products described by the EPA and others in epidemiology research simplistically as cigarette smoke or tobacco smoke. An ethical malaise exists in the fraudulent representation in the research of the smoke defined as a single dimensional disease vector. This would explain the vast diversity of outcomes as a result of these studies and in perspective how much value they truly represent. In an overall inspection of the outcomes, the larger studies have consistently shown inconclusive results in ETS research.

The WHO study although the conclusions were largely ignored, the findings should have shown; when taken into perspective a margin of error the study was marginal or in respect to curative indications in children’s studies, to be a pretty good indication of the limitations of this research method. Elimination of physical science from the evaluation was deceptive. Research based in environmental controls and ingredients regulations based in product safety are well known to be much more suitable for the task at hand. Widespread victim bashing was financially beneficial to all parties or stakeholders involved, including the product manufacturers, however a strategy based in deceit is destined to fail.

Further in evaluating the credibility of the presentation included it needs to be understood; deaths formerly attributed to other sources are now possibly associated to and more likely to be caused by PM2.5 the former associations would understandably decrease significantly. In some cases, the RR factor of these disease categories would require re-evaluation in deciding significance if any, in human population and reduced ETS advocacy relevance.

Information from the ALA website the latest research indicates the following;

Daily exposures to Particulate matter result in premature death three times greater than previously reported.

Some of the highlights of the more than 50 new studies summarized include:

A long-term study showing risk of premature death attributable to PM is three times greater than previously reported;

• Studies linking daily exposures in PM with increased hospital admissions for strokes, congestive heart failure, heart attacks, COPD and other respiratory problems;

• A toxicology study showing links between exposure to PM2.5 at levels near or below the current standards and development of atherosclerotic plaques;

• Many studies elucidating the biological mechanisms and pathways for cardiovascular effects;

• Studies linking prenatal exposure to air pollution with increased risk of low birth weight, preterm birth, infant mortality, and cancer;

• Research showing that coarse particles exacerbate respiratory disease;

• Three meta-analyses linking ozone air pollution with premature mortality and a multi-city study showing that effects are not due to temperature;

• Intervention studies showing that reductions in air pollution yield measurable improvement in children’s respiratory health and reduction in premature deaths; and

• Policy analyses showing the need for strong annual and daily fine particle standards to protect susceptible populations and provide equivalent levels of protection to different regions of the country.

Links to the full articles or abstracts are provided. A copy of the bibliography is attached.

Attached files

2005 Research Highlights: Air Pollution and Health

( 1-32-2005 2005 Health studies final.pdf 357.56 KB )

Highlights of 2005 Health Studies on PM and Ozone

ALA Testimony at Chicago Public Hearing

( ALA testimony Chicago Public Hearing PM NAAQS 3082006.doc 55.00 KB )

Testimony of Janice Nolen 3-8-06

Testimony of George Thurston

( EPA_GDT_testimony061.doc 106.00 KB )

4-6-05 testimony at Philadelphia public hearing





Holiday Inn Historic District

400 Arch St.

Philadelphia, Pennsylvania


MARCH 8, 2006

I am George D. Thurston, a tenured Associate Professor of Environmental Medicine at the New York University (NYU) School of Medicine. My scientific research involves investigations of the human health effects of air pollution.

The adverse health consequences of particulate matter are serious and well documented. This documentation includes impacts demonstrated by controlled chamber exposures and by observational epidemiology showing consistent associations between this pollutant and adverse impacts across a wide range of human health outcomes. Unfortunately, the implementation of the NAAQS standards proposed by the U.S. EPA on January 17, 2006 will fail to provide sufficient public health protection to the American people, as is called for by the Clean Air Act, and as indicated is necessary by the latest air pollution health effects science.

Particulate Matter (PM) air pollution is composed of two major components: primary particles, or "soot", emitted directly into the atmosphere by pollution sources such as industry, electric power plants, diesel buses, and automobiles, and; "secondary particles" formed in the atmosphere from sulfur dioxide (SO2) and nitrogen oxide (NOx) gases, emitted by many combustion sources, including coal-burning electric power plants.

Observational epidemiology studies have shown compelling and consistent evidence of adverse effects by PM. These studies statistically evaluate changes in the incidence of adverse health effects in a single population as it undergoes varying real-life exposures to pollution over time, or across multiple populations experiencing different exposures from one place to another. They are of two types: 1) population-based studies, in which aggregated counts of effects (e.g., hospital admissions counts) from an entire city might be considered in the analysis; and, 2) cohort studies, in which selected individuals, such as a group of asthmatics, are considered. Both of these types of epidemiologic studies have confirmed the associations of ozone and PM air pollution exposures with increased adverse health impacts, including:

- decreased lung function (a measure of our ability to breathe freely);

- more frequent respiratory symptoms;

- increased numbers of asthma attacks;

- more frequent emergency department visits;

- additional hospital admissions, and;

- increased numbers of daily deaths.

Among those people known to be most affected by the adverse health implications of air pollution are: infants, children, those with pre-existing respiratory diseases (such as asthma and emphysema), older adults, and healthy individuals exercising or working outdoors.

The state of the science on particulate matter and health has undergone thorough review, as reflected in the in the recently released U.S. EPA Criteria Document for Particulate Matter—of which I am a contributing author. Since the fine particle (PM2.5) standard was set in 1997, the hundreds of new published studies, taken together, robustly confirm the relationship between PM2.5 pollution and severe adverse human health effects. In addition, the new research has eliminated many of the concerns that were raised in the past regarding the causality of the PM-health effects relationship, and has provided plausible biological mechanisms for the serious impacts associated with PM exposure.

In my own research, I have found that both ozone and particulate matter air pollution are associated with increased numbers of respiratory hospital admissions in New York City, Buffalo, NY, and Toronto, Ontario, even a Furthermore, I was Principal Investigator of an NIH funded research grant that showed, in an article published in the Journal of the American Medical Association (JAMA), that long-term exposure to particulate matter air pollution is associated with an increased risk of death from cardio-pulmonary disease and lung cancer, as displayed in Figure 1 (Pope et al, 2002). In fact, the increased risk of lung cancer from air pollution in polluted U.S. cities was found in this study to be comparable to the lung cancer risk to a non-smoker from living with a smoker. Thus, the health benefits to the U.S. public of reducing long-term exposures to particulate matter can be substantial. But the January, 2006 EPA proposal ignores this new science, and the ignores the sound scientific advice of its own CASAC panel of scientists. The EPA NAAQS proposal therefore also fails to sufficiently protect the U.S. public from this serious health risk.t levels below the current standards. These results have been confirmed by other researchers considering locales elsewhere in the nation and the world, as documented in the most recent PM Criteria document, which was prepared by the EPA staff and reviewed by the EPA’s independent Clean Air Scientific Advisory Committee.

Figure 1. Lower PM2.5 Levels Are Associated with Lower Mortality

Source: Pope, Burnett, Thun, Calle, Krewski, Ito , and Thurston. (Journal of the American Medical Association, JAMA, 2002)

Especially a problem is the fact that the EPA Administrator has ignored the new information regarding the increased risk of lung cancer and cardio-pulmonary mortality now known to be associated with long-term exposure to PM2.5. For example, new scientific documentation from both epidemiological studies, such as the JAMA paper I co-authored (Pope et al., 2002), and toxicological studies, such as the recent JAMA article showing increased accumulation of plaque in the hearts of mice as a result of long-term PM exposure (Sun et al., 2006), are effectively ignored by the Administrator

The Administrator has instead chosen to raise and over-emphasize certain scientific issues in order to support his inaction on the issue of protecting the public from the dangers of long-term PM air pollution exposure. For example, the preamble to this decision (Federal Register, January 17, 2006, Vol. 71, No. 10, pp. 2652) raises education and sulfur dioxide (SO2) as issues. These comments in the preamble do not represent a full and balanced consideration of all the facts. Indeed, when the HEI Reanalysis of the ACS data reported these associations, they also noted that “The Reanalysis Team concludes that this modifying effect is not necessarily attributable to education per se, but could indicate that education is a marker for a more complex set of socioeconomic variables that impact upon the level of risk.” The Pope et al. (2002) study does correct for these issues through the inclusion of education indices. Similarly, the HEI report also notes that the SO2 association with mortality was unlikely to be causal, but was more likely a marker of another component of the air pollution, stating: “ The absence of a plausible toxicological mechanism by which sulfur dioxide could lead to increased mortality further suggests that it might be acting as a marker for other mortality-associated pollutants.” Based upon my own recent analysis, it is apparent that SO2 is acting as a marker for coal combustion fine particle pollution in this PM2.5 dataset. However, the HEI Reanalysis report’s clarifying statements are ignored by the Administrator. In no way do these factors, fully considered, take away from the scientific evidence, both from the ACS and other studies, that long-term exposure to PM2.5 is causing needless deaths every year. They also do not justify the Administrator’s ignoring of the ACS JAMA manuscript and the other recent studies providing confirmation of PM’s long-term adverse health effects, and additionally indicating mortality impacts even larger than that reported by the ACS study (e.g., from the Veterans Cohort by Lipfert et al, 2003; and from the 6-Cites Study cohort follow-up by Laden et al., 2006).

Instead of a balanced and full view of this issue, the Administrator apparently decided to selectively choose the “scientific intelligence” that fit the decision he wanted to make, as has ignored the overwhelming evidence that ran opposite to the proposed decision to do nothing to further protect the American people from the health dangers of long-term exposure to PM pollution. EPA’s own analyses (U.S.EPA Staff Paper, 2005) indicate that the Administrator’s inaction on this standard will result in thousands of avoidable deaths each year. I hope that the Administrator will reconsider this decision, listen to the advice of the health experts on CASAC, and instead act to lower the annual PM2.5 standard, thereby avoiding thousands of needless deaths in the U.S. each year. I recommend an annual standard of 12 ug/m3.

As to the short-term (24-hour average) standard proposed by the Administrator, the level chosen is insufficiently stringent to adequately protect the public health. It is so lax that it provides little public health benefits when compared with the present standard. Indeed, the study of older adults in more than 200 counties across the nation that was released today in the prestigious journal, the Journal of the American Medical Association (JAMA), further documents that short-term excursions of fine particle air pollution are associated with a significant increase in the daily risk of hospital admissions from cardiac and respiratory causes. (I have attached a copy of that new paper to my testimony for your examination.) Even eliminating all days above 35 ug/m3 from consideration from the study (as per the U.S. EPA’s proposed standard) failed to change the conclusions of this study, with significant associations still being found between PM2.5 exposure and excess cardiac and respiratory admissions at levels of PM2.5 below 35 ug/m3 (Personal Communication, Francesca Dominici, March 8, 2006). In my view, the available science supports a short-term PM2.5 standard of 25 ug/m3, in order to most appropriately protect the health of the U.S. public.

Thank you for the opportunity to testify on this important issue.


Dominici F, Peng RD, Bell M, Pham L, McDermott D, Zeger J, Samet J. (2006). Fine Particulate Air Pollution and Hospital Admission for Cardiovascular and Respiratory Diseases. J. Am. Med. Assoc. (JAMA). March 8, 2006 Vol. 295, No. 10, pp 1127-1134.

Krewski, D. et al. Reanalysis of the Harvard Six Cities Study and the American Cancer Society Study of Particulate Air Pollution and Mortality: Investigators' Report Part I: Replication and Validation. 2000. Health Effects Institute, Cambridge, MA.

Lipfert FW, Perry HM Jr, Miller JP, Baty JD, Wyzga RE, Carmody SE. (2003). Air pollution, blood pressure, and their long-term associations with mortality. Inhal Toxicol. 2003 Apr 25;15(5):493-512.

Laden F, Schwartz J, Speizer FE, Dockery DW. Reduction in Fine Particulate Air Pollution and Mortality: Extended follow-up of the Harvard Six Cities Study.

Am J Respir Crit Care Med. 2006 Jan 19.

Pope, C.A. III, Burnett, R.T., Thun, M.J., Calle, E.E., Krewski, D., Ito, K., and Thurston, G.D. Lung cancer, cardiopulmonary mortality and long-term exposure to fine particulate air pollution. J. Am. Med. Assoc. (JAMA) 287(9):1132-1141 (2002).

Sun Q, Wang A, Jin X, Natanzon A, Duquaine D, Brook RD, Aguinaldo JG, Fayad ZA, Fuster V, Lippmann M, Chen LC, Rajagopalan S. (2006). Long-term air pollution exposure and acceleration of atherosclerosis and vascular inflammation in an animal model. JAMA. 2005 Dec 21;294(23):3003-10.

U.S. EPA (2004). Air Quality Criteria for Particulate Matter (October, 2004). EPA/600/P-99/002aF. National Center for Environmental Assessment, Office of Research and Development. Washington, DC.

U.S. EPA, (2005). Review of the National Ambient Air Quality Standards for Particulate Matter: Policy Assessment of Scientific and Technical Information OAQPS Staff Paper. EPA-452/R-05-005. Office of Research and Development, Washington, DC.