Disease and deception in the Caribbean

I first heard of Coral Rosa from a fellow prisoner in the US federal detention centre. Coral Rosa, then seven years old, was born and raised in the seemingly pristine island of Vieques, in Puerto Rico, only a few miles away from elysian beaches that are beautiful beyond belief. Also a few miles away from her home was a US military training site. For sixty years, Vieques was shelled continuously with tens of thousands of bombs every year. The mortality rate due to cancer in Vieques is 20 percent higher than the rest of Puerto Rico. Coral, a cancer survivor, is missing her stomach and intestines. She turns nineteen this year.

From 1999 to 2003, thousands of citizens, including me, peacefully protested the military exercises and were imprisoned. Ten years ago, the Navy stopped bombing Vieques, but the legacy of these bombings has continued. In 2005, Vieques was designated by the Environmental Protection Agency as a “Superfund site” – a glamorous name for a toxic dump. If you think your home or place of work is far away from a toxic dump, or that this history of Vieques has little to do with you, think again. Half of Americans live less than ten miles from a Superfund site.

In Vieques, as in other Superfund sites, the agency in charge of evaluating the effects of pollutants on population health is called ATSDR (Agency for Toxic Substances and Disease Registry). But for the past thirty years, ATSDR has consistently failed to find “credible scientific evidence” to link pollutants to public health problems in communities neighbouring Superfund sites. These scientific studies provide an illusion of safety to the general public while they put our health at risk.

Take the case of Camp Lejeune, NC. For over thirty years, US Marines and their families bathed in and drank polluted tap water contaminated with carcinogens. Cancer, miscarriages, and birth defects were noted in people who drank the contaminated water. ATSDR conducted a study from which it concluded that a link between the polluted water and the health problems was unlikely; but, twelve years later ATSDR had to retract their “flawed” findings. Or the case of FEMA trailers contaminated with formaldehyde (a known carcinogen). Hurricane Katrina survivors living in the trailers were beset with eye irritation, breathing problems, and nose-bleeds, though ATSDR research indicated that there was no connection between the formaldehyde and these symptoms. Later studies demonstrated that the ATSDR research and public health recommendations were flawed and they were forced to revise their studies.

Which bring us back to Vieques. Previous studies had established that military practices contaminated Vieques with mercury, napalm, benzene, lead and depleted uranium. Some of these chemicals are known carcinogens, and all are hazardous pollutants. Like Coral Rosa, residents of Vieques have poorer health outcomes than elsewhere in Puerto Rico. Yet a report released just last month from ATSDR claims its scientists could not find “credible scientific evidence” to support the link between the military pollutants and the poorer health of Vieques residents.

Déjà vu

As a professor and a scientist at Yale University, finding credible scientific evidence is what I do for a living. In science, lack of evidence to support a hypothesis is called “negative data”. Negative data can be misleading if studies are not conducted correctly. A deeper dive into the studies used by ATSDR reveal a number of flaws.

First, ATSDR used studies conducted by US Navy contractors to draw conclusions about Vieques, while ignoring findings from other independent researchers. Also, the studies were poorly designed, specifically faulted for poor environmental sampling practices.

For example, if you visited Connecticut in the middle of the summer, and did not find snow, you would lack scientific evidence that it snows in Connecticut. But it would be due to poor sampling, in this case, sampling during the wrong season. And it would be ridiculous to conclude that it never snows in Connecticut or to base policies on that negative data.

When studying contamination in fish, instead of obtaining fish from the affected and contaminated areas, ATSDR used data from fish sampled at the Vieques town market, without knowing where the fish originated. And in spite of flawed sampling, the fish were found to have high levels of methylmercury (three times higher than the national standard recommended by the National Academy of Sciences).

Methylmercury is a highly toxic compound linked to cardiovascular disease. In Vieques, the incidence of cardiovascular disease is higher than the rest of Puerto Rico. Yet, when ATSDR release its recommendations, it ignored the standards of safety and stated that the detected levels of methylmercury was safe for the people of Vieques.

ATSDR drawing conclusions from poorly designed studies is not unique to Vieques. They are actually quite routine for the agency. Many scientists believe ATSDR scientific studies are “inconclusive by design”. University scientists and non-profit organisations have conducted rigorous, independent studies (which have undergone the stringent scrutiny of the scientific peer-review process) and call into question ATSDR findings. But when it is time to integrate scientific recommendations into policy, by law, regulatory agencies like the Environmental Protection Agency receive their recommendations from ATSDR.

There are real and damaging consequences to ATSDR’s inconclusive studies. When ATSDR failed to find credible scientific evidence linking the polluted water with the cancer cases in Camp Lejeune, those findings were used to justify the denial of benefits to veterans for over a decade. When ATSDR failed to recognize the danger of formaldehyde exposure on the residents in the FEMA trailers, it resulted in FEMA allowing tens of thousands of families to live in the toxic trailers for another year. And now in Vieques, as ATSDR again fails to find a lack of credible scientific evidence between the pollution and the poor health of Viequenses, that has directly translated into a lost decade of misguided policies and unnecessary exposure of Viequenses to mercury and other contaminants.

The use of inconclusive scientific evidence to distract from the very real impact of pollutants in health is as old as the environmental movement itself. Fifty years ago, when Rachel Carson published the book Silent Spring, which catalysed the modern day environmental movement, chemical companies used quasi-scientific studies to claim there was no credible scientific evidence linking pesticides such as DDT and adverse human health and environmental outcomes. Today, ATSDR is using tax-payers’ dollars to produce the inconclusive studies which are stifling the execution of environmental justice.

There is enough credible scientific evidence that ATSDR is failing to fulfil its mission of protecting the health of Americans from hazardous pollutants. This summer, as we reflect on the accomplishments of the environmental movement, let’s not forget that saving the planet and our health, takes more than just planting a tree or recycling a can. It takes asking Congress to take a long, hard look at the failing ATSDR model and telling them that the 100 million Americans living near Superfund sites deserve better than studies which are predictably “inconclusive by design”. 

Daniel Colon-Ramos is an Assistant Professor in the Department of Cell Biology and the Program in Cellular Neuroscience at the Yale school of Medicine and is a Public Voices Fellow with the OpEd Project.

You can follow Daniel on Twitter @dacolon