Saturday, September 13, 2014

Musings: Looking for Answers

I recently wrote a post that questioned the current politicized approach to dealing with agricultural pesticides on Kauai, and noted that blood and urine tests can reveal the presence of agricultural chemicals in the body. I asked why none of these tests were being done to offer proof of pesticide exposure from the chem/seed companies. 

I received this comment from Pat Gegen, which I think is worthwhile to share:

Regarding the testing of the 75 chemicals you referenced - tests are available to test for specific or groups of chemicals and the metabolites they produce but they are very costly and not covered by health insurance. A basic test I am aware of that covers approximately 75% of the chemicals identified in the Waimea lawsuit used by Pioneer costs over $750.00. A test to determine the level of glyphosate in a person's system by it self cost me just under $100.00. Those are large amounts to spend on testing for individuals.



The doctor who expressed concerns that some birth defects may be 10 times the national average and need to be studied was Dr. Raelson who works out of KVMH. This was based on babies just delivered by himself and a few other providers on Kauai (study size was approximately 750 births if I recall correctly) - This does not include folks who may live on the westside but delivered somewhere else due to higher risk situations. His letter is in the public realm as it was submitted as testimony during deliberations of 2491.

I recognize that lab tests are expensive — though I'm not sure that none are covered by insurance if a doctor thinks they are needed — but still, why haven't some of the ant-GMO groups funded even a few such tests?  Hawaii SEED has spent tens of thousands of dollars bringing speakers here -- money that could've been used to accumulate some data and give worried families some answers. And what about the plaintiffs in the case against Pioneer?  Hasn't even one family paid out of their own pocket to find out for sure? I am not saying it is the responsibility of westsiders to prove they are being poisoned by pesticides, but still, hasn't even one person checked?

I also found an "open letter" from Dr. Jim Raelson, which I am reprinting here so that people can see for themselves what he really said:

Several people have asked about comments I made regarding birth defects (specifically cardiac defects) at the meeting we had a couple weeks ago with Kauai County Council members. I would like to clarify what I said at that meeting and share my thoughts on the issue. Dr. Chatkupt and I have for some time commented to each other on what we felt were an unusual number of certain birth defects in the population delivering at KVMH. Putting our heads together we seem to have a cluster of complex congenital heart defects. A few comments though about that:

1. There is no good data. I have learned that there has been no active Hawaii Birth Defects surveillance since 2005. In my verbal phone conversation with the director of the program I learned that due to administrative issues and the change of the program from UH to DOH there has been a lapse of the registry. DOH recognizes this deficiency and importance of having the data and has started an effort to resurrect data going back to 2005. A very informative complete report of hawaii birth defects broken down by year, type, county was published for the years 1986-2005:






but there is no reliable data after 2005. 

The only numbers that Dr. Chatkupt or I have is from our involvement the last 7 years with most of the significant cases of birth defects and our recollections. Some of our mothers deliver in Lihue and some in Oahu; we would not know about cases we had no clinical involvement. Also many serious birth defects including cardiac defects result in 1st and 2nd trimester spontaneous Ab's; which often would not be diagnosed.

2. Health Events clusters. Like cancer clusters, birth defects clusters need to have epidemiological evaluation to determine if the observed unusual incidence in a population is statistically significant or could occur by statistical chance alone. Because the population of our westside deliveries is so small I think this would require quite some time (years) to prove statistical significance. Certainly however DOH does have responsibility to collect and look at the data and do the epidemiological studies.

That being said, of particular concern is the incidence of serious cardiac malformations; particularly those that result from early embryogenesis defects that have occured in our population the last three years. We have had 5 major cardiac defects that have required early extensive surgical repair in San Diego the last 3 years: 2 cases of Transposition of the Great Vessels, 1 Hypoplastic left heart, 1 Hypoplastic Right heart with heterotaxy and 1 severe pulmonary stenosis. 

The transposition cases and hypoplasia cases are considered defects that occur in early first trimester. While cardiac birth defects are the most common birth defects these particular types of lesions are rare. 

Recent CDC statistics puts transposition at 1/3300births, hypoplastic Left heart at 1/4344 births and hypoplastic right at 1/17000 births. In the last 3 years we have had about 750 deliveries ; this gives us an incidence of 53/10,000 births for these 4 defects. National US data shows an incidence of 5.5/10,000 births, so we have 10 times the national rate. 

Interestingly, the report published for Hawaii's numbers from 1986 to 2005 showed an overall small downward trend over these years in total birth defects but with an increasing trend in transposition of the great vessels and pulmonary atresia.



The point I tried to make to Council members was that we don't know for sure if we truly have a problem of true clusters because it has not been adequately studied but as clinicians we are seeing suspicious clusters of disease. We also don't know about cause and effect but if we are seeing a true cluster of a disease that has been linked to low level exposure by good studies done elsewhere then that in itself is grounds for real concern that we are seeing serious health problems. One of the things to advocate for is tfor CDC and DOH to do the unbiased epidemiology studies and to do bio-monitoring. As an example CDC recently did a study in central Washington of the birth defect anencephaly because they were seeing a fourfold increase in that defect over national data. 

So as I've written before, has anyone, like Gary or the anti-GMO groups, asked the CDC to do such a study? Instead of pursuing the EPHIS, which as currently designed will be a highly-politicized and expensive process unlikely to deliver reliable, respected data, why not ask a qualified outside agency to come in?

Also, if you take the time to look at the birth defects registry, you will see that factors such as inadequate pre-natal care, very young mothers and drug and alcohol use are the most frequent causes of birth defects in Hawaii. When you consider also that drug overdose — both prescription and illegal — is the most common cause of accidental death in Hawaii, is it possible that the ice and oxycontin epidemic in Hawaii could be playing a role if there is indeed a birth defect cluster?

Yes, it could be pesticide exposure, but it could be due to other factors, or a combination of things. I've often wondered how many people on the westside have heavy metal poisoning due to the lead paint and arsenic in the canec drywall used in the old plantation homes.

I personally got very, very sick from such exposure while renting an old home in Anahola. I paid out of my own pocket for medical tests that verified high levels of lead and mercury, and also for tests that documented elevated lead levels in my house. As a result of those tests, I got the proper treatment and I moved.

I am not trying to minimize any real health concerns that are taking place on the westside or elsewhere. My point is only that we need more information. I feel it's irresponsible for politicians to be blaming one possible source and stoking people's fears, without any real evidence. Responsible politicians and activists would be seeking answers, not court rulings and media coverage.

36 comments:

Anonymous said...

I too often wonder why groups like Hawaii-seed who spend hundreds of thousands of dollars printing books and having events wouldn't donate money to the poor families that they so often talk about. Factual tests would give so much more power to the argument. And if they found the chemicals were found in their blood, then they proved contamination and drift beyond a doubt.
That said, if you live anywhere near pesticides and your children are sick, it would be smart to find another place to live and see if the symptoms change.
Some people are far more sensitive to chemicals and pesticides than others.
Are the kids at Island school affected as the GMO fields surround there too? Or is it only the west side that feel the affects of poison? Like princeville poison is sprayed on the golf course for rich people so it's OK and doesn't make us sick?

Anonymous said...

Testing is expensive.
But DOH, CDC and especially EPA will respond to a claim by an MD.
Remember, these organizations are staffed by by essential watchdogs. And their mindset is to catch evil doers.
Testing is essential for truth.
But wild claims and suppositions that flame emotion and fear are so much more fun and effective in turning out a vote.
Besides, there is an unusually large population of retired Cane workers and families in Waimea and Kekaha, that for generations lived with the dust, spray, runoffs and swam in the 'kukai" ditches that ran near the ocean.
There seems to be an extraordinarily large population of these older folks on the Westside. Maybe some testing can be done on them for cumulative long term effects. Back then the chemicals were stronger and the safety standards were zippo.
Of course these 80 and 90 year olds are pretty active and they may not have time to talk to what they may feel are some niele outsiders trying for tell them how for live.
One thing for sure, most of these kapuna will be voting. And it won't be for Hooser or Bynum. JoAnn will get some because she is a nice young Japanese girl. Talk to the real people who have lived with DDT, mosquito fog jeeps, Bull Durham faucet bags on household water and the other real life impact of big ag controlling all aspects of life.
You might be surprised at how healthy they are.....but they all did eat a lot of fish, have gardens and did exercise.
JoAnn at least the big evil cane growers gave a single family house to the people instead of stuffing them into over cost County apartments.

Anonymous said...

Thanks again Joan. Pat Gegan, Gary Hooser and Tim Bynum all beat to the same drum. Dr. Jim Raelson is a well respected doctor. His comments are loud and clear that he doesn't have the data to form any conclusions. As usual, Tim and Gary took parts of the doctor's comments out of context and exploited them to their advantage. They are not interested in finding solutions. They are interested in making names for themselves to serve their self interests. Pat Gegan is just an antagonizer. He doesn't care about real facts either. Spin, spin, spin. So easy to do but so detrimental in the pursuit of real solutions. Placing fear in peoples' minds is not being responsible. But that is what they do. They all need to go. Including Pat Gegan.

Anonymous said...

It sure seems like the Anti's don't want to do the testing as they're scared the findings would undermine their claims.

Anonymous said...

How do I get in contact with you Joan?

Joan Conrow said...

eastsidegrrrl@yahoo.com

Anonymous said...

Pat Gegen's hypocrisy knows no bounds. While publicly siding with the anti GMO movement for popularity purposes, as a member of zero waste Kauai he peddles and advocates the use of one of the GMO industry's biggest products...biodegradable plastics. Even Tim's plastic bag ban encourages the proliferation of GMO bio plastic bags. Oops I think I just waked up and rised all over their face.

Anonymous said...

Does anyone else think it's weird that Gary spent all of last year saying the state was inept in handling the Ag and pesticide issues but is about to embark on a crusade that would allow the state to controll all water usage on Kauai? Gary is so ignorant and crooked I don't know how he manages to screw on his pants every morning.

Anonymous said...

It's really sad how Gary has toyed with the emotions of mothers desperately seeking answers for their children's lives to just leave them high and dry, emotionally drained without any real answers or solutions. And the only thing they can do to fight the boogie man he's created is vote for him in November.

Gary has co-opted the Hawaiian culture, he's massaged, groomed, pet, and embraced the egos of the youth for his own perverse agenda. Fern, Dustin, malia chun, his son, mason, and especially these vulnerable mothers are merely victims of his sexual politics.

Joan Conrow said...

Btw, Pat Gegen is married to Marghee Maupin, the nurse practitioner who has leveled many of the accusations.

Anonymous said...

BTW, Pat Gegen made his fortune on Big Oil before he retired and moved here to bully all of us with his sustainability agenda. Hypocrisy to the max.

Anonymous said...

it's really sad how people....

Anonymous said...

Do you have proof of Gegan's former affiliation with big oil? I really woud like to see it.

Anonymous said...

What Pat Gegen stated about blood tests is common knowledge. But his desire to grand stand with the best, Gary and Tim makes him one of them. And off course his nurse practitioner wife Marghee is not an RN..

Regarding the Zero Waste program, that's a joke. The only way we might reach anywhere close to Zero Waste would be to reinstate the Taylor Camp lifestyle for all people of Kauai. Pat Gegen is just another mainlander trying to exploit whatever he can from the County and Kauai.

So to arbitrarily say we need to close down GMO Ag on Kauai because blood and urine tests are too expensive is ludacris.

Dawson said...

Anonymous 2:36 PM said:

it's really sad how people....

...Twist positions of public leadership into opportunities for self-aggrandizement?

...Turn the trust of those who elected them into disdain and contempt?

Yes, and yes.

Anonymous said...

The next time you see Pat ask him about his "12 years in the energy industry" http://m.thegardenisland.com/news/local/candidate-by-petition-pat-gegen/article_01ae8eb0-637a-11e1-bcd8-001871e3ce6c.html?mode=jqm

Anonymous said...

In the comment made by the doctor about his and his colleagues' observations of the births on the westside, there was no mention that there are now a good number of women having their babies at KVMH who don't live on the westside. They come from all parts of Kauai. So it seems, at best, that all of this information doesn't mean anything until in depth studies can be performed.

Dee Morikawa said...

This is another good article Joan. Last session there was a bill at the legislature to mandate doing the Hawaii Birth Defects Registry. Although the bill didn't pass, all hospitals have committed to do this. We will see it they actually do; otherwise you will see introduction of a bill again. It is important to get data according to zip codes.

Joan Conrow said...

Thank you for the update, Dee.

Anonymous said...

From LinkedIn:
Pat Gegen
Rotating Equipment Manager
Flint Hills Resources
April 1996 – August 2007 (11 years 5 months)

Manage 40 pump mechanics and responsible for the reliability and repair of all rotating equipment in the refinery.

hawaiifarmersdaughter.com said...

After all of the brouhaha and the tearing apart of the community is the truth coming forth and the real questions being asked. The manipulation of emotion overrode all common sense and rational thinking to ever allow a decent fact finding investigation from ever happening. Now everyone is paying the price for all of this all across the state. That is the most unfortunate thing of all of this.

Anonymous said...

Agree, Most rational people base their decisions on facts and not emotion. Fact finding should have been the first step. I'm glad that Dee Morikawa is taking the lead in starting the process. Kudos to Dee. The Board of Health should also be involved to provide blood tests for any mother on the island having a birth defect.

Anonymous said...

"Pat Gegen
Rotating Equipment Manager
Flint Hills Resources
April 1996 – August 2007 (11 years 5 months)

Manage 40 pump mechanics and responsible for the reliability and repair of all rotating equipment in the refinery."

Pat, I know you reading this. Please explain.

Anonymous said...

3:23 said "And off course his nurse practitioner wife Marghee is not an RN."

You must be an RN to be a nurse practitioner.

Anonymous said...

Its purty f'in' easy to get stats.
There are only 2 insurance companies....and of course, the Welfare system....

Pat Gegen said...

Anonymous said...

Pat, I know you reading this. Please explain.

September 14, 2014 at 8:22 AM

Feel free to give me a call or email if you want more information… Not sure what needs to be explained??
psgegen@hotmail.com
808-635-2081

Joan Conrow said...

This isn't about Pat. I appreciate his comment and the information he shared.

Anonymous said...

@9:13 what chemical background does a RN / Nurse Practitioner have in diagnosing any kind of a chemical fault? Again saying it's too expensive to come up with the truth is not a very professional comment.

Anonymous said...


September 14, 2014 at 12:58 PM
Blogger Joan Conrow said...

This isn't about Pat. I appreciate his comment and the information he shared.

September 14, 2014 at 1:05 PM

way to moderate the discussion, Joan! sometimes the comments are ...a bit unprofessional.

Anonymous said...

Everything relies on money.
If the County wants air, water, dust etc. testing. Let the County allocate some money for these purposes.
But there is no money. The County is broke. The Council passes a budget, knowing there is no money. It passes bizarre knee jerk tax laws to capture money to break even. The new tax laws hurt people, so the County proposes more knee jerk laws to alleviate the hurt. It is byzantine.
The Council can not even do a simple (yes folks, a budget is easy) budget.
And we the people put our trust in a bunch of nimrods who have difficulty with the simple arithmetic needed in a budget to assess, evaluate and effectuate GMO/Herbicide science?
I know the brainiacs in the anti-Ag movement are smarter than Einstein and to them horizontal gene transfer, molecular cloning, recombinant DNA and other aspects of GMO engineering is simple dimple.
But, Great Fog of Hyperbole Batman, it don't matter what we do. We are all doomed with this Council. And especially with the fearless four of Bynum, Hooser, Chock and Yukimura who have no cents at all. Jay has some sense, but he has lost it for a while.
Tim Bynum possesses super scents.

Anonymous said...

It is a problem in general where someone offers an idea or a point of view, every hater they ever had sees it as an open invitation to smear the person or their spouse, or their children in the comments. No wonder the pols get so jaded.

Anonymous said...

@5:19 welcome to the real world. Except for the children. That's a no-no.

It was never like that until the westerners brought their attitude and self righteous style to the islands. The blogs, and deception was also introduced. The locals caught on fast and now have combated attitude with attitude.

Anonymous said...

Wow Pat, really? I am one of your six step children who have accrued 79K in school loan debt. I could use your help to pay this back with your big oil fortune, which I have just found out you have via this blog! You and I are going to have a talk!

Ok seriously, I am one of his step daughters, and sadly there is no fortune. I've known him for a long time and trust me, there is no ulterior motives or efforts to exploit the marginalized. Oh and my mom IS a RN and an APRN and I'm quite surprised with how interested you all are in either of their history and qualifications. I find them quite boring.

Anonymous said...

yes, it takes a true sleuth to find something on a person's public linkedin profile page, a true modern sherlock holmes. pat gegen, how dare you have such a scurrilous history of... managing people and putting your free time into community service. to think that gives you a right to have an opinion about your community's future. what nerve!!

Anonymous said...

The judge said pesticides are the state's responsibility, not the county. What's the state doing?

Anonymous said...

It doesn't pay to make enemies on Kauai. They eyes of the people are crystal clear.