Published in the Boston Phoenix on February 12, 1999. Copyright © 1999 by the Boston Phoenix Inc. All rights reserved.
By Dan Kennedy
In the February 8 issue of the New Yorker, Atul Gawande — a surgical resident and research fellow at the Harvard School of Public Health — argues that it’s virtually impossible to find evidence that environmental contamination causes cancer. Gawande’s article, “The Cancer-Cluster Myth,” is well researched and impressively argued. But there is a curious omission: any mention of Woburn and its unusually high rate of childhood leukemia.
Between 1969 and 1986, 21 Woburn children were diagnosed with leukemia, a number that was approximately four times higher than would be expected in a community of its size. Following two decades of study, the Massachusetts Department of Public Health concluded in 1996 that the elevated leukemia rate was strongly associated with exposure to water from two contaminated wells that were closed in 1979. The study’s findings, according to the DPH, “suggest that the risk of developing childhood leukemia was greater for a child whose mother drank water from the contaminated wells while pregnant with the child.” The effect was especially pronounced, the DPH added, in homes that received most of their water from the two wells.
Suzanne Condon, director of the DPH’s Bureau of Environmental Health Assessment, says Gawande spent more than an hour interviewing her. Yet neither Condon nor the Woburn study appears anywhere in his article. Instead, Gawande relies on the expertise of Raymond Richard Neutra and Alan Bender, epidemiologists well known for their skeptical attitude toward attempts to link pollution and cancer. “Particularly in Woburn, how anybody could believe that what happened was by chance is ridiculous,” says Condon. “The only thing I’m happy about is that he didn’t use my name.”
Indeed, so deliberate did Gawande appear to be in ignoring the Woburn experience that he managed to slip in the name of Jan Schlichtmann — the lawyer who sued two alleged polluters on behalf of eight Woburn families — without even mentioning the case that made him famous. Instead, Gawande offered a lengthy discussion on the laws of probability and the likelihood that the vast majority of cancer clusters are merely random occurrences. “Given the exceedingly poor success rate of such investigations,” Gawande wrote, “epidemiologists tend to be skeptical about their worth.”
Gawande, when reached by the Phoenix, declined to discuss his omission on the record, although he emphatically defended his article. And it’s true that even the DPH doesn’t contend that its findings amount to any more than a strong statistical correlation. Still, the DPH study was an enormous advance that stands in contrast to Gawande’s thesis. Even if he thinks it’s unimportant, it was intellectually dishonest of him to ignore it.
An overview of the DPH’s findings is located on the Web at http://www.magnet.state.ma.us/dph/beha/woburn.htm.