Jewish World Review April 2, 2002 / 20 Nisan, 5762

Drs. Michael A. Glueck & Robert J. Cihak

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The scoop on soot: A dirty rotten shame? | Sigmund Freud once remarked that sometimes a cigar is just a cigar. Our subject today is soot, and the fact that, sometimes, soot is just soot.

But sometimes also more.

The media have taken an interest in soot of late. Specifically, they've been sensationalizing an article from a prestigious medical journal, thereby unnecessarily (but intentionally?) scaring and worrying the public.

A study in the Journal of the American Medical Association (JAMA) for March 6 proclaims that soot -- particulate matter released into the air by coal- fired power plants, industrial facilities, and even Mother Nature -- is an important environmental risk factor for cardiopulmonary and lung cancer mortality. The authors imply that they can identify who and how many were killed outright, and who died prematurely because of exposure to soot. Their proof? A statistical correlation between disease rates and pollution levels.

That correlation may well exist. However, by itself it proves nothing. If ninety percent-plus of all murderers eat potatoes and bread, should we take fries and ryes off the market? The authors assert that they tried to correct for other factors. However, so far they've stonewalled requests for their primary data from other independent scientists. So there! -- let us have no non-JAMA peer review that might impugn the research and also, thereby, the Journal.

This is no mere scientific quibble. The EPA and its state-level equivalents often use such studies to justify regulations that impose both financial and medical costs on all Americans. And science by news release and second- hand reportage affects the climate of opinion in a decidedly sooty matter. So in the interest of clearing the air, let's first decide how sooty it really is, how many have died, and where it all fits in the great scheme of things.

Soot is tiny. It takes 20 billion particles to fill a pea. Now, things you can't see CAN hurt you. But enough of them have to be concentrated in space over a critical period of time. Some of the victims of the Mount St. Helen's eruption died because they breathed in enough ash (natural soot) to block the air passages to their lungs. But the vast majority of people in the vicinity inhaled only a few particles and suffered no ill effects. Even old Sigmo had to smoke twenty cigars a day for decades before contracting cancer. (Could there be an connection between cigar- induced mild asphyxia and some of his patients' confessions?)

Of course, the authors of the JAMA study aren't talking about that kind of demise. Their primary concern is statistical death, especially premature statistical death -- the deaths of people who might have lived longer, save for the soot. Now, those are rarely, if ever, real deaths to which names can be attached. They're guesstimates. Recall the furor in the 1950s? -- 50,000 deaths a year worldwide owing to residual fallout from atmospheric nuclear testing! Did 50,000 people succumb? Perhaps. Perhaps the number was 100,000. Perhaps it was zero. No one can know. Guesstimates, especially politically motivated guesstimates, aren't science.

Now, nobody's claiming that chronic exposure to soot is good for you. But the fact is, we're a long way from the heavy pollution of a century ago or even a few decades ago. Back then, it made both medical and economic sense to clean up most of the soot. But then the Law of Diminishing Returns set in. How much would it cost to clean up the rest?

Some experts estimate as much as $100 billion a year, or more than $300 per person. Would it be worth it?

The answer must be based on both medical and financial factors. Economics holds that the true cost of anything includes its opportunity cost -- the alternatives foregone. Spending $100 billion a year means that both the people and the government have that much less to maintain health and enhance life. Such a redeployment of resources might actually cause more deaths in other ways. Throughout the Industrial Revolution, life expectancy increased in the most polluted urban centers precisely because cities offered other benefits -- including better health care than that found in the countryside. (Adam Smith understood it clearly.)

So if soot is much less of a problem than before, and if there is no direct proof of public health and epidemiological impacts, and if it wouldn't be cost- effective to remove it, should anything be done?

Well, there's always nuclear power, which has killed far fewer people than coal, gas, or oil- fired power generation, and which can be made even safer than it is already. But again, politics trumps science. Perhaps for now, the best thing would be for people to start developing some long-overdue skepticism about overhyped hazards, statistical deaths, and sooty reasoning. Maybe we can all take another pointer from Dr. Freud. Whenever you encounter one of these studies, reflect:

I wonder what they REALLY mean.

Michael Arnold Glueck, M.D., of Newport Beach, Calif., writes on medical, legal, disability and mental health reform. Robert J. Cihak, M.D., of Aberdeen, Wash., is president of the Association of American Physicians and Surgeons. Both JWR contributors are Harvard trained diagnostic radiologists who write numerous commentaries and articles for newspapers, newsletters, magazines and journals nationally and internationally. Comment by clicking here.


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