Musings: "Implausible, Irresponsible and Incomplete"

Dr. Graham Chelius, a Board Certified Family Medicine physician who practices in Waimea, and lives in Kekaha, submitted some insightful comments to the Joint Fact Finding Group on agricultural pesticides on Kauai.

As you may recall, Dr. Chelius previously published a letter to the editor soundly refuting Councilman Gary Hooser's oft-made — and unfortunately, oft-published — claim that the westside had a birth defect rate 10 times the national average.

Dr. Chelius' comments on the JFFG report are so thoughtful and informative, from both a common sense and public health perspective, that I thought they should be shared with the general public:

I appreciate the immense amount of work that went into the report; however, I found the report to be amateur, incomplete, biased and irresponsible.

Here are some areas that need to be rectified:

As stated in the AAP policy "Pesticide Exposure in Children" which you cite, the greatest source of pesticide exposure for most children is food. Your report completely ignores this. Where are the recommendations to test for pesticides in school meals which many Westside children eat twice a day during the week? Who is monitoring for pesticide residue at Big Save and Costco? Who is educating the public about the greatest risk of exposure? The report should clearly state this fact. The report found virtually all testing for pesticides on Kauai to be very low level if found at all, suggesting that while monitoring should continue, the exposure risk to humans from agricultural use is lower than from other sources.

Even mentioning a non-peer reviewed unpublished high school science project smacks of desperation. This pathetic level of biased disregard for scientific integrity pervades the entire report. Only high quality data should be included. Including the opinion of a retired EPA employee from Chicago who did no original research on the Waimea Canyon School events is another example of laughable lack of scientific rigor.

Much of the report focuses on RUPs, without addressing if they are a greater health and environmental risk than GUPs. Then GUPs, such as glyphosate, are discussed at length without any data regarding the use pattern on the island, which certainly includes significant home, golf course and governmental use.

The explanation of the difference between causation and correlation in the appendix apparently did not translate to the report. As the report shows there are high rates of smoking, obesity and diabetes on the Westside. These exposures are known to be causative regarding a number of cancers, birth defects and developmental problems in offspring. 

Using your own language in the appendix, it is implausible that the low levels of pesticide exposure that the numerous studies have demonstrated on the Westside are responsible for the burden of disease found here. That is the difference between causation and correlation, and it is irresponsible to confuse the public by creating the impression that pesticides have caused disease on the Westside. An epidemiologist should have sat on the panel and one is needed to rewrite the health section. Also it needs to reflect the reality that it is very unlikely that the low levels of pesticide exposure that have been measured are causing any health effects when compared to the known risks of high rates of smoking, obesity and diabetes.

There are a number of residents on the Westside who suffer with kidney failure, all of whom have a known causative exposure, mostly diabetes and hypertension. It is important to note in the report that the one study you cite did not show low level pesticide exposure to cause kidney disease, it is only a correlation, and can be explained by changes in modern lifestyle and agribusiness. More pesticides of certain types are being used and people are generally more sedentary and eat differently causing more obesity, diabetes and hypertension. This again shows a level of bias that is irresponsible. First off, one study doesn't mean anything. Second, there are obvious other causative factors at play. It is so unlikely that pesticide exposure has anything to do with kidney disease on the Westside that even including it without clearly stating that is ridiculous.

Finally, $3 million is a huge amount of money that could be spent on far greater threats to the health of our community. In the last few years, there has been three motor vehicle deaths with in a 1 mile radius of my house, but no pesticide related deaths. Where is the $3 million for traffic cameras and police patrols? There is a very busy dialysis unit and frequent early deaths caused by diabetes on the Westside, where is the $3 million for case management and prevention? The children on the Westside have high rates of poor dental health, obesity and diabetes, where is the 1000 foot buffer zone for sugar around the school? Not addressing that there are well documented causes of disease which are more common and threatening than the minuscule pesticide exposure you found is shameful. 

Wasting our limited resources on what has essentially become a witch hunt against Westside Agribusiness is disgusting.

Yes, monitor for continued compliance with the law but clearly state that you came up empty handed, all of the tests show low levels, often due to legacy agricultural use, there is absolutely no scientific evidence of actual harm to humans or the environment, and the most likely exposure most people will have is from the store through food or home use of pesticides. 

As a comparison, we soon will have Zika virus spreading to Hawaii. Zika very likely causes birth defects and is not some long shot correlation based on sketchy data like much of the JFF report. Are we going to be so overwhelmed with fear of pesticides that people will resist mosquito control efforts? It will be interesting to see if we come full circle and embrace vaccines and pesticides when we see what an actual threat looks like.