This post is intended as a companion piece to my story in the current issue of Portland Monthly, Are Portlanders Anti-Science?.
Below, in no particular order, are several anecdotes, ideas and facts that I originally wrote for that story, which were cut from the final text in the interest of clarity and concision.
I’d like to invite readers to use the comments section below to discuss the PM story, or any other related topics. As always, I enthusiastically welcome constructive criticism and dissenting opinions, but let’s all agree to avoid unfounded accusations of conspiracy (I swear, I’m not being paid by Monsanto, pharmaceutical companies, or “Big Fluoride”) or general nastiness, ok? Vigorous debate is awesome, name-calling and personal attacks, not so much. Thanks.
Births, babies and vaccines
Despite priding ourselves on being a health-conscious city, Portland leads the nation in elective home births. This seems to be a growing trend locally, despite the fact that numerous studies show the risk of infant death is much higher for home births compared to being in a hospital. But then again, maybe hospitals aren’t the safest places to have a baby? [EDIT: I was asked to provide more support for the claim that the risk of infant death is higher in home births, and I should have done so. This research article is the best citation I can find on the subject. It’s a fairly recent (2010) meta-analysis that summarizes the results of 7 studies on the subject, which were selected for good methodology. The overall finding of these 7 studies is that home births more than double infant mortality, from .09% to .20%. In the combined study groups, 16,500 infants were delivered by home birth, and approximately 16 more infant deaths occurred than would have been expected if they had been delivered in hospitals.]
My friend Dave and his wife had a child at OHSU hospital in 2013. About 18 hours after their daughter was born, a social worker from Multnomah County came to their room to record the birth. This person was wearing a surgical mask and Dave, concerned for his brand new child, asked if they were sick. “No, I don’t believe in vaccines, so I have to wear this mask.” What? Why would OHSU hire someone who doesn’t “believe” in vaccines to speak to new parents? How many parents go home with both a new baby and new doubts about vaccines?
I spoke to representatives from OHSU about this incident, and they would not comment on specific employees, but they confirmed that, yes, they do permit unvaccinated employees to work in rooms with medically fragile patients and newborns, as long as they wear a facemask. They also said that, hypothetically, OHSU would support a policy that requires employees to be vaccinated, but (as mentioned in the PM article) state law currently precludes common sense policies like that.
I was also told, by State Representative Mitch Greenlick (also a professor of public health) that a lot of the opposition to mandatory vaccine policies (on a state level) comes from nurses unions (?!?) because they believe that such a policy would be used as a pretext to punish nurses and that doctors would not be held to the same standard. I have trouble, however, believing that many doctors would choose not to be vaccinated (yes, I’m aware of “Dr.” Jack Wolfson, but to be fair, he’s an osteopath, not an MD, and in my opinion, osteopath’s are barely ‘real’ doctors—the entire osteopathic tradition, much like acupuncture, is founded on unverified anatomical beliefs that simply don’t correspond to actual human physiology—and many osteopaths practice a lot of nonsensical treatments, like using massage to treat pneumonia and other infectious diseases.) Even if this was true, however, it’s a cynical position and it’s really poor policy (and fairly ironic) for nurses unions to prioritize workplace politics over public health.
Vaccines and school employees
Like hospital workers, school employees in Portland also are not required to be vaccinated. I spoke to representatives from Portland Public Schools about this and they also said that they would like to have such a policy, but cannot because of State law. I asked them what they did to ensure that school employees (not just teachers, but custodial staff, kitchen workers, coaches, bus drivers…) did not put students at risk of preventable diseases. I was told that they have a policy to affirmatively protect student health by removing sick employees from classrooms and directing them to a doctor if necessary. They could not recall, however, the last time this policy was used but were sure it had been “at least several years”.
A little bit more about fluoride
In addition to conspiracy theories, the opposition to fluoride in Portland was based on many bad arguments, such as an oft-repeated desire to “keep chemicals out of our drinking water” despite the fact that water itself is a chemical, and nobody seems to mind that we already add chlorine, ammonia and sodium hydroxide to our water in order to disinfect it and prevent corrosion of pipes. (Side note: the irony award goes to an anti-fluoride protestor who was seen standing on MLK avenue, holding a sign that said “Fluoride is Poison”, while smoking a cigarette…cognitive dissonance much?)
Another common claim of fluoride opponents, such as Clean Water Portland, the main opposition group, was that fluoride would “add a substantial amount of arsenic to the city’s tap water”. While technically this claim was true, it was also entirely misleading and was clearly a disingenuous attempt to scare people—which is a pretty sleazy tactic typically employed by cynical, dishonest actors, not people with truth on their side.
Estimates from Clean Water Portland’s own research claimed that fluoridation would “potentially” increase arsenic levels in drinking water by as much as 0.12 parts per billion. That might sound dangerous, but the natural arsenic level in our water is already ten times that high, and many common foods such as rice, apple juice, fish and tea contain hundreds or thousands of times as much arsenic. Eating a single tuna sandwich would give you more arsenic than drinking 9,000 glasses of fluoridated water, even at the alarmist levels CWP claimed.
More examples of bad public policies in Portland
Failing to consider scientific information leads directly to bad public policies. For example, the local environmental movement recently celebrated a “major victory” in banning plastic bags in Portland, despite the fact that doing so didn’t meaningfully improve the environment. Yes, paper bags are made of a renewable resource and biodegrade faster, but compared to plastic bags their manufacture requires about four times as much energy and creates far more pollution and greenhouse gases.
I don’t really have any strong objection to “banning the bag” (it’s pretty much a wash from an environmental perspective) but it’s really a shame that the local environmental community (which I consider myself part of) spent several years and a lot of money on this issue. The opportunity cost was staggering—instead of making progress on important environmental problems like carbon dioxide emissions or pollution in our rivers, most of the community was consumed with passing feel-good legislation that failed to make any real impact on our environment.
Similarly, last year the Portland Water Bureau, wasted 38 million gallons of drinking water because some idiot urinated in a reservoir. Of course that’s gross, but it only resulted in the water being roughly 0.00000197% urine (which is mostly water anyway) and it poses no actual danger to people who drink the water. Bizarrely, at the same time, we accept the known risk of waterfowl swimming and defecating in the same reservoirs, which is a well-known health risk.
All scientists get paid for their research
This isn’t specifically relevant to Portland, but it’s a point that I think bears mentioning here: all scientists work for money, whether it’s a salary from a company, or a grant from the federal government. Consequently, we all face pressure to produce results that conform to the prejudices of our funding sources. For example, if a biologist studies a species of butterfly and gets her funding from the Nature Conservancy, she might face a problem if her work shows that the butterfly species is doing well—because, of course, the NC depends on public donations to fund their work, and it’s hard to raise money if you are telling people that everything is fine.
This isn’t a fatal problem though, because the hallmark of good science is reproducibility, not a single published study. If other scientists can reproduce findings, using the same methodology, then they are good results and will be accepted by the community—it really doesn’t matter if the original study was funded by Monsanto, the NSF or Greenpeace (who have an annual budget of about $400,000,000.00 and really should fund more research and less propaganda). Nonetheless, in public debates about things like vaccines and GMOs, I constantly hear research dismissed as “industry funded” as if that somehow changes the validity of the results.
(Side note to folks who make this criticism: who should fund research into the safety of vaccines and GMOs? Should taxpayers have to subsidize the work of for-profit companies and spend public money to prove that these products are safe? Or should the for-profit companies bear the financial burden?)
I don’t want to whitewash concerns about dishonest results though—it’s certainly true that a lot of medicines have been approved for public use based on flawed results, and that many negative findings are simply not reported to the FDA. This problem should be addressed with legislation that requires public reporting of all studies, as well as publicly funded comparison studies that compare the efficacy of new, expensive drugs to older, cheaper ones.