 |
 have been
struggling for ten years to investigate leukemia among young people in the
vicinity of the French nuclear waste reprocessing plant, at La Hague. I
began trying to establish a cancer register, which was lacking at that time.
My research was peaceful and confident up to November 1995, when I published
a spatial analysis highlighting a peak of leukemia incidence in the electoral
ward (named "Beaumont-La Hague") containing the nuclear plant.
(Viel JF, Pobel D, Carre A., "Incidence of leukemia in young people
around La Hague nuclear waste reprocessing plant: a sensitivity analysis."
(Statistics in Medicine 1995;14:2459-72.)
 Although I was cautious, avoiding
any causal link between the plant and the disease peak, the attacks on me
began. This turned into a harsh controversy in January 1997 with the results
of a case-control study I had conducted in this area (Pobel D, Viel JF.
"Case-control study of leukemia among young people near La Hague nuclear
reprocessing plant: the environmental hypothesis revisited." (British
Medical Journal 1997; 314:101-6.) I found that the more often children
played on the beach or consumed local fish or shellfish, the more likely
they were to develop leukemia. Relying on several arguments (dose-response
effect, the strength of the associations, lack of temporal ambiguity, consistency
with Scottish results), I concluded that there was "convincing evidence"
for a causal relationship.
Soon after, I was fiercely condemned
for my findings. Local politicians held me personally responsible for alleged
damage to the local economy, due (according to them) to flawed results brought
to the attention of the public through an unknown medical journal (i.e.,
the British Medical Journal).
Late January, I was informed by newspapers
and the National Medical Council that the president of the Council of the
departement de la Manche -- the administrative area containing the nuclear
plant -- was threatening a lawsuit against me. From January to July 1997,
I was the subject of attacks and libels. This did not seem to rouse other
French epidemiologists to action. My support came from the British Medical
Journal, some newspapers like Le Monde and the French ministry
of the environment.
My worst attackers consisted of local
representatives, the French medical research institute, one official institution
named Office for Protection Against Ionizing Radiation, and Cogema -- a
state-owned company operating the La Hague nuclear plant.
In July, the integrity and relevance
of my research work was recognized. However, I was pressured to reveal the
identity of study participants, and provide personal data acquired in my
survey to other groups. I have refused both, since in the application file
to the "French national committee of data processing and freedom,"
and in the documents to the participants, I had committed not to do so.
More precisely, I had received an official approval from this committee,
provided (1) any link with any name would be destroyed after the usual data
check; (2) data access would be restricted to the medical staff of my team
under my personal responsibility; (3) any data transmission to anyone (individual
or institution) would be strictly forbidden; (4) only anonymous and aggregated
data would be published; (5) all these statements would be reported upon
the informed consent signed by the parents. I have respected these rules.
Scientifically speaking, it can appear shocking, but it was a matter of
ethics and deontology for me. I was committed to respect these rules, so
I held on, keeping my personal responsibility towards the parents.
In July 1997, I was under the threat
of two lawsuits. One was due to the mayor of Beaumont-La Hague -- the village
where the plant is located -- threatening to sue me to court for the offense
of "disinformation." I received this information through an American
journalist from the New York Times.
Things are getting slowly better.
Threats never turned into genuine lawsuits but my scientific credibility
is still called into question. In the meantime, I have received modest support
from my university, and from the French ministry of education, since I am
allowed to get in touch with a lawyer if I am sued.
I have published a book for lay people
in France, entitled Public Health Atomized (ISBN 2-7071-2827-9).
I describe the evidence coming from the British studies, the details of
my case-control study, the pros and cons of any epidemiological study, the
causal inference process in epidemiology, societal reactions (slanders,
diabolism...), deficiencies of the surveillance system in France, tough
French regulations on the use of nominal and census data, and the convergence
of interests between industrialists, politicians, and some scientists.
I know better than most how powerful
the nuclear lobby is. I have experienced attacks and intimidations at the
expense of my professional and family life. As a consequence, I am concerned
about the role of environmental epidemiologists. On the razor's edge between
industry and community activists, they are operating in a rapidly evolving
society. They should, in my opinion, demonstrate a humility about the scientific
research process and an unrelenting commitment to playing a supportive role
in larger efforts to improve public health. Citizenship and environmental
equity are of primary concern. However, they should not be left carrying
this heavy burden alone. Public support is warranted by epidemiology's vital
role in shaping public health policy and practice. It is time to enter a
new societal contract between citizens, politicians, and scientists, one
which is based on principles of innovative science and social justice.  |
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