January 1995 (vol. 11, #2) 1601 N Tucson Blvd #9, Tucson AZ 85716 c 1995 Physicians for Civil Defense


Mark Twain once said that ``there are lies, damned lies, and statistics.'' What he should have said is that there are liars, damned liars, and those who distort and misuse statistics.

The science of statistics is actually a powerful weapon in the search for truth. Those who take the trouble to learn the basic mathematics and to look at the data themselves can use statistics to shred the arguments of manipulators and scaremongers.

One of the best teachers was Petr Beckmann, author of The Elements of Applied Probability Theory. Back issues of Access to Energy provide useful and entertaining examples, explained in layman's terms. (Complete sets of back issues are now available on paper from Irene Beckmann for $145, Box 1342, Boulder, CO 80306, or on CD-ROM from the present editor Arthur Robinson, $95, Box 1250, Cave Junction, OR 97523). Additionally, there is an excellent discussion in the February issue of AtE. If you have trouble with these, you may need to borrow a Saxon math book from one of your children. (If they attend public school, they are unlikely to have one; books from elementary texts through calculus can be ordered from the Thompson School Book Depository, PO Box 60160, Oklahoma City, OK 73146.)

Statistics are very useful for determining whether an unusual (perhaps disastrous) event is occurring, and also for evaluating the possible causes.

Here are a few questions to test your understanding:

1. What percentage of the population is average?

2. What is the significance of a value that is twice the average?

3. If 20 independent tests are performed on a perfectly healthy individual, what is the probability that at least one will be outside the normal range?

4. Is an agent that doubles the incidence of a certain cancer of greater public health concern than one that increases the incidence by only 50%?

5. If two entities are always (or frequently) found in association, can we conclude that one causes the other?

Radical reformers, who wish to impose disastrous changes on society, have to convince people that there is a catastrophic threat. Instead of stating actual numbers, which might not sound impressive, they may make a comparison with the average.

It can be rigorously proved that exactly 0% of the population is precisely ``average.'' By definition, exactly half the population is above average, and exactly half is below. We need to know just how far above or below average a certain value is. And to say that it is ``twice'' the average is in itself meaningless, unless we know the shape of the probability distribution function. In other words, is the bell-shaped curve fat or skinny? Normal variability may be so great that 30% of the population has a value at least twice as high as the mean.

For example, consider Disease X, which normally affects 1 in 10,000 people. If we randomly select 10,000 people from the population, the chance that two or more persons will have disease X (giving a prevalence of at least twice the expected) is 26%, by chance alone. (This is calculated from the binomial probability distribution function, described in any standard statistics text or see ``Medical Poll-bearers and Statistical Malpractice'' by Jane M. Orient, J Med Assoc GA, Aug 1993, reprints available on request).

Besides the normal range, one must know the error of the measurement. You cannot be sure that a temperature is 1 degree higher than the mean if you are using a thermometer with an accuracy of ± 0.5 degrees. Furthermore, you need to know the error of the mean, which depends on the number of measurements. For example, if you determine the IQ of only a dozen individuals, the mean may be far different from the true mean of the entire population. If you test 10,000 persons, you are far more confident of having a representative sample.

The pitfalls of a small sample size should be obvious. Yet many highly paid ``decisionmakers'' easily forget this fact. They may, for example, decide to deny insurance coverage to patients of a physician who has a ``higher than average'' rate of Caesarian sections, based on a small and highly unusual group of patients.

The third question relates to the fallacy of ``fishing expeditions.'' If a plaintiff's lawyer wants to build a case against an occupational exposure, he can always find a disease that is present in ``statistically significant'' excess providing that he looks at enough diseases. He will also find just as many with lower than normal incidence, but you can bet no one will claim that the exposure is protective!

The precise answer to question 3 (again from the binomial distribution function) is a startling 64%, if ``abnormal'' is defined to be a value more than two standard deviations from the mean. Thus, the presence of a certain amount of abnormality is actually quite normal. (Because of this, large batteries of screening tests can be very lucrative: patients often need still more tests to check on the first set of results.)

If multiple comparisons are made in an experiment, the criterion for statistical significance must be more rigorous. And if an association ``turns up'' that was not part of the original hypothesis, it must be checked out in an experiment specifically designed for that purpose.

Another common error is to place more emphasis on a purported ``doubling'' of a rare disease such as brain cancer or leukemia and to downplay a smaller percentage increase in a common tumor such as breast cancer, especially if the proposed etiologies are more or less politically correct. A student research project: estimate the amount of ink, in column-inches per life at risk, devoted to cancers of various proposed causes.

It is impossible to overemphasize the importance of the answer to question 5. Even if all the statistics are done right, a correlation does not prove cause and effect. A perfect correlation may result from two variables having a common cause. On the other hand, lack of correlation can disprove causation.

How can the literate nonscientist acquire immunity to statistical disastermongering? When evaluating a scientific report, start with the following steps: (1) Look at the raw data, not just the ``averages'' and the conclusions. If there are few data, be wary. (2) Check the sample size, the method of selection (was it random, or biased?), and estimates of the error of measurement. (3) Consider possible uncontrolled factors that could influence the results. (If it's a cancer study, were the effects of smoking and age considered?) (4) Were multiple comparisons made? Was the significance criterion changed accordingly? (5) Is the result merely a correlation, or is there a plausible mechanism for causality? Are quantitative changes in the proposed cause (e.g. ozone level) related in the expected way to the effect (e.g. UV level, see p. 2)?


Breast Cancer Correlations

Breast cancer is a common disease, accounting for 18% of all cancer deaths in women. Moreover, the incidence has been increasing in recent years; some have referred to the increase as an ``epidemic.'' Small percentage increases in incidence affect a large number of women because the disease is so common.

Environmentalists are quick to blame industrial pollution for the increase, even though such pollution has been decreasing in recent decades. Environmentalist writings do not include dose-response curves (graphs of breast cancer incidence as a function of level of exposure to suspected carcinogens).

It is reasonable to expect that breast cancer might be induced by hormones, and environmentalists make much of the weakly estrogenic effects of chlorinated organic com-pounds, such as polychlorinated biphenyls (PCBs) and dioxin. However, women exposed to high doses of PCBs in industrial settings over 50 years do not have a higher incidence of breast cancer. And in Seveso, Italy, women exposed to dioxin due to an in-dustrial accident actually have a lower incidence of breast and en-dometrial cancer 15 years later (ACSH Priorities 4:#6, 1994).

These exposures to industrial estrogenic chemicals are trivial when compared with natural exposure to the products of that internal factory known as the ovary. And there have been dramatic changes in factors affecting endogenous estrogens in recent years: decreased age at menarche, delayed childbear-ing, decreased numbers of pregnancies, and legalization of abortion.

Women who have their first pregnancy at a young age and bear lots of children are at lower risk for breast cancer. Nuns are at higher risk. It is possible that pregnancy-induced matura-tion of the milk-producing cells makes them more resistant to carcinogens.

Many scientists have asked what might happen if the milk glands start to proliferate but never complete the process due to interruption of a pregnancy. A 1980 study showed that a first-trimester induced abortion prior to the first full-term pregnancy was associated with a 2.4-fold increase in the risk of breast cancer (Pike, Br J Cancer 43:72-76, 1981). Other studies have shown inconsis-tent results. The most recent study of 845 women and 961 controls, all born after 1944, showed that an induced abortion was associated with a 50% increase in breast cancer (Daling, et al. JNCI 86:1584-1592, 11/2/94).

This result was released with little fanfare. An accompany-ing editorial stated that ``it is difficult to see how [the overall results] will be informative to the public.'' The author advised against focusing on the cancer risk and recommended a ``bal-anced consideration of the entire range of relevant issues,'' cautioning that ``neither a coherent body of knowledge nor a convinc-ing biologic mechanism has been established.''

[Bibliography available upon request.]


Arizona Lawmakers Challenge CFC Ban

A bill approved by the House Environment Committee in the Arizona state legislature would allow the possession, use, manufacture, transportation, or sale of CFCs in the state of Arizona after the international production ban takes effect at the end of 1995. The committee thereby decided to ``defy the federal government and much of the rest of the world'' (Ariz Daily Star 1/27/95).

Another bill asks the federal government to lift the ban because ``federal restrictions...are based on unreliable and unsubstantiated scientific studies conducted by individuals using scare tactics in support of their so-called environmental agen-da.'' The plea calls for balance: ``Any trivial benefits to be not warrant the economic and social costs resulting from such drastic and unnecessary measures'' (Tucson Citizen 1/26/95).

University of Arizona professor William Sellers, identified as an ``atmospheric scientist,'' objected because lifting the ban might kill certain species, such as shrimp.

``We do know there have been times in the past that certain species have become extinct and we do know there were times when the ozone layer was badly damaged, and I'm not entirely convinced there couldn't be an association between those occurrences.''

The killing mechanism is supposed to be an increase in ultraviolet light. Jane Orient, MD, challenged opponents of the bill to produce one piece of paper graphing stratospheric ozone concentrations against surface ultraviolet radiation levels. If UV does not increase as ozone decreases, the rest of the argument about atmospheric chemistry vanishes into stratospherically thin air.

The only purported evidence for an increase in UV, during 1993 when the effects of Mt. Pinatubo reached a maximum, was rushed into print (Science 262:1032-1034) without benefit of such a graph or the data the reader would need to construct one for himself (see Access to Energy, January, 1994). This is probably because the desired effect does not occur. The most important variable is probably solar intensity, which increases both UV intensity and ozone production, so that UV levels at the surface are generally stable.


CFC Smugglers Caught

Two men face up to 20 years in prison and more than $2.2 million in fines for importing 8,400 cylinders of freon without paying the excise tax of $4.35 per pound. Instead of being shipped to Mexico as false paperwork asserted, the refrigerant was destined for sale in New York, New Jersey, and Florida (UPn and AP, 1/18/95).


HIV and AIDS: Correlation vs. Causation

Everybody ``knows'' that the human immunodeficiency virus causes AIDS. Yet some scientists remain skeptical, including noted virologist Peter Duesberg. They claim that Koch's Postulates have never been satisfied (the organism must be isolated from a diseased individual and be shown to cause the disease in another)-and many AIDS researchers agreed, until a lab worker developed Pneumocystis pneumonia 68 months after a laboratory accident that infected him with HIV (Science 12/9/94). The correlation is certainly strong, but not perfect. And the issue is muddied in that the diagnosis of AIDS relies heavily on detecting antibodies to HIV. The dissenters think that other risk factors (especially drugs) are causative. That correlation is also strong but not perfect. Identifying risk factors has the same problem as relying on self reports of abortion in breast cancer studies.

In this issue also, the self-correcting mechanism of science is imperiled when political correctness enters the process.