Twelve Million Dollars Later

Someone, perhaps someone you know, just got cancer.  Brain tumor - rare, but not that rare.  An unparalleled tragedy to be sure, but it happens.

In John Shea and John Greco’s day, the cavernous Pratt & Whitney Aircraft plant was filled with an oily mist that sprayed from the grinding machines, coated the ceiling and covered the workers, who came home drenched in pungent machine oil. Degreasing pits, filled with solvent for cleaning the engine parts, dotted the factory floor; workers used squirt cans of solvent to clean their hands and clothes. Shea spent 34 years grinding engine blades and vanes at the million-square-foot facility in North Haven, Conn. In 1999, at age 56, he was diagnosed with brain cancer. Six months later Shea’s friend and co-worker Greco learned he had the same disease: glioblastoma multiforme, the most aggressive type of brain tumor. A year after Shea’s diagnosis, both men were dead, but their widows had already begun asking questions about the seemingly unusual number of cases of this deadly form of cancer at one of the world’s top jet-engine manufacturers.

In the case of the Pratt & Whitney workers, there were more instances of this rare and deadly form of cancer than would normally occur in a similar population without the chemical exposure detailed above.  Or at least the statistics seem to indicate that.  The quotation above is from a Scientific American article (March 2008, p. 86) in which details are given of a $12 million study that should quantify exposures and risks of a large cohort — 250,000 workers over 50 years — employed by P&W.  The Scientific American article is a summary of what the study (which is due to be completed within a year) hopes to discover.  Due to the large size of the cohort and the detail of the data, they are hoping to uncover more subtle effects of exposures and working conditions on various conditions and diseases experienced by the workers.  The SA article is a summary, and if I describe it in any more detail, this will be a summary of a summary.  You're better off reading the original but you'll need to either subscribe or pay for it.  Sorry. 

Why You Keep Me Around

At this point you're probably wondering why you keep me around, since I haven't said much about the study, and haven't even provided a free copy of the article.  Of course I have a good answer:  You keep me around because I have already divined the results of this $12 million study before it's complete.  I don't have all the details, of course, that's why they use professional statisticians.  But I do have the broad outline, and it is this:

They will soon have discovered that chemical exposures do, in fact, result in an increase in cancer cases.  (Perhaps this will start the lawsuits flying, although many of the cases are ancient.)  They will draw a number of correlations between what chemicals and what processes cause a handful of industrial diseases.  Some of these will have a strong statistical association and some will be much weaker, verging on chance.  These correlations will be lovingly detailed in a number of academic papers and recommendations for regulations.  Some recommendations will be fought, others will be acquiesced to.  And, mirabile dictu, lives will be saved, albeit at enormous cost.  A victory will be declared, and the $12 million, plus the uncounted millions (or billions) spent on compliance will be considered worthwhile.

Am I Sounding Skeptical?  Or Even Sarcastic?

Picked that up, eh?  Well, I am and I'm not.  For one thing, I do believe some useful information will come out of the study; for another, I'm always happy when actual scientists get their turn at the public trough.  But, if I may offer a brief quote from the part of the article that isn't on-line:

After seven years and $12 million, there is a good chance the Pratt & Whitney study will wind up like so many other workplace health investigations:  inconclusive.  Researchers say the phenomenon stems from the difficulty of the science...

And perhaps it does, but that isn't my take on it at all.  I would argue that it isn't so much that it is difficult as that it is not "science."  Nor, presumably, are the other inconclusive studies that in the aggregate cost a lot more.  Nor, tragically, but unsurprisingly, are the occasional multi-million dollar verdicts in favor of this person or that who may or may not have gotten sick or died due to a chemical exposure or environmental hazard.  Fact:  I have a friend who died from lung cancer who didn't smoke and spent a lifetime exhorting anyone who would pay attention to not smoke.  Another fact:  Most smokers don't die from lung cancer.  (Further additional fact, in case you think I'm going to make an argument for smoking:  Unlike the study mentioned above, and others with weak or statistically uncertain conclusions, smoking is about as dangerous as anything you can do that doesn't involve explosives or a lot of gravity.)

But back to the "conclusion" of the study in Scientific American.  Please reread the first quote, with the pungent machine oil, degreasing pits, and squirt cans of solvent.  The first question that popped into my 1,1,1,-trichloroethane-soaked cranial unit is:  With that description, why didn't everyone get cancer?  I don't think that anyone actually knows the answer to that.  Consider three cases:

• 1:  True poisons, e.g., hydrogen cyanide.  It will kill you and you and you and everyone else. 

• 2:  Relatively benign chemicals, e.g., sodium chloride, which is necessary for life and will only damage you in seriously excessive quantities (although it has been linked to high blood pressure in some).

• 3:  Pretty much everything else - insecticides, industrial solvents, manufacturing byproducts, etc.

The problem with #3 is hinted at above:  In a tiny handful of people, cancer or other serious disease results from exposure, while the vast majority appear to suffer no ill effect at even much higher doses.  (If everyone suffered similarly, it would fit in category #1.)  Unfortunately, because there is some (valid) statistical data but very little science behind the danger of exposure to these chemicals, vast sums are spent to keep exposures low for the entire population.  What we really need is some frightfully expensive research that could examine this question:

Assume that one in 100,000 people normally get a particularly rare brand of cancer absent exposure to any known causative agent, and one in 10,000 people (10 times as many, but still very few) get it at a low level exposure to a particular suspect chemical.  Does this mean that people in general are sensitive to this chemical and are likely to get cancer from it with a bit more exposure?  Or does it mean that those nine unfortunate souls are particularly sensitive to that chemical at almost any level and that most people aren't sensitive at all?  That is the crucial question that the P&W study will almost certainly not answer.  Does it matter?  Very much so.  If only a tiny percentage of people are sensitive to a chemical, they shouldn't go near it and should avoid workplaces where it is present.  Meanwhile, if the vast, vast majority of people are not sensitive, there is no benefit to protection and great economic saving in spending less effort to control exposure.  Of course the opposite is true:  If it's a population-wide sensitivity, then exposure should be reduced almost regardless of cost.

The Trough

Since (so far as I know) there is no way to determine a specific individual's sensitivity to various chemical exposures, statistics and expensive studies seem to be the best we can do, even if the results are "inconclusive."  But wouldn't it be nice if the trough were full enough to pay for real research?  If you could take a genetic sample from a prospective employee and determine that this is the one person in ten thousand who should be working anywhere but here?  Yes, I know that's "discrimination," but if we were scientifically clever enough, it could also be reality. 

Swiss Cheese

If you're wondering why, besides sloth on my part, The Face in the Cheese has been on display for so long, I'll offer an answer soon, plus or minus sloth.

NP:  "The Invisible Man" - Marillion

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