Abstracted from “A Scientists View of Almost Everything”
By Mark M Green
Hoosick Falls is a lovely town in upstate New York near the Vermont border and famous as the home of a remarkable painter: Grandma Moses. As of recently, it is a famous town for the discovery that a chemical associated with the production of stick-free cooking ware, perfluorinated octanoic acid (PFOA), is at a level in drinking water found in town wells, that is more than suspected of causing maladies as serious as cancer. Excellent evidence of the danger of PFOA is that the corporate source of the water contamination is handing out free bottled drinking water in a local market.
The suspicion of one town resident about the death of his father led him to get a test of his drinking water. What was discovered led to frustrating conflicting announcements (!!) from both the federal Environmental Protection Agency and the New York State Department of Health about the danger of PFOA and related chemicals in the town’s drinking water. Both agencies depend on laboratory results, but much too often problems of this kind are not first detected or evaluated by analytical chemistry, but rather by the observations of people living in affected areas. Such observations belong to the category of epidemiology, or to put it in other terms, how coal miners have protected themselves. Many years ago, coal miners, fearing noxious gases, including deadly carbon monoxide in the mine, would carry canaries with them. The bird with its rapid respiration and small size would keel over long before the miners were affected allowing time for escape. Unfortunately, the residents of Hoosick Falls were the “canaries in the coal mine” for the presence of PFOA in the supposed potable water in their town. All too often laboratory tests involving minute amounts of chemicals that nevertheless are dangerous to health do not reveal the danger. It takes the effect on our bodies to reveal the problem.
Epidemiology, as I learned from Wikipedia, is constructed from the Greek language (as are many scientific terms): epi—upon; demos—people; logos—study. There are some very interesting historical examples of the value of epidemiological studies, which are the foundation of the field of public health, taking us from supernatural sources of disease to a rational scientific basis for illness and death. Hippocrates (460 to 377BC), the source in modern terms of the advice to doctors to “do no harm,” is given credit for being the first epidemiologist. For example, he pointed to the fact that yellow fever and malaria occurred most often in swampy areas, leading to a rational rather than a supernatural basis for these diseases and a way to protect oneself. It was only thousands of years later that Walter Reed, an army physician, made the connection to mosquitoes. But Hippocrates observation gave the essential clue. Hippocrates focused much attention on the source of water people drink, which may have affected how John Snow (1813-1858) tried to track down the recurrent source of cholera in London in the 1800s. Taking an epidemiological approach Dr. Snow made a connection to parts of the city served by distinct sources of water and proved his point by removing the handle from one water pump causing a sudden drop in cholera cases by people using that pump. This was before the bacterial source of disease was accepted but demonstrated that something was in the water and that the source of cholera was not some mysterious miasma in the air.
There is the example of Ignez Semmelweis, a medical doctor in Vienna who observed the difference between two clinics in a maternity hospital. In one, women were dying in large numbers from what was called childbed fever. In the other, far fewer met this fate. Doctors were coming directly from autopsies to the deadly clinic without washing their hands. After hand washing was strictly required, deaths from childbed fever dropped precipitously, although the reason for washing was not known in this time before an understanding of the germ theory of disease. In another convincing example, before the sources of disease were understood, it was observed in many places all around the world that servants who milked cows would often get cowpox but would be immune to small pox leading to one of the foundations of the discovery of the value of vaccination first proposed for this problem by Edward Jenner (1749-1823).
There is so much more demonstrating the continuing value of this science. For one example, did we understand the reason why people who smoked got lung cancer among other maladies? We were the canary that demonstrated the danger of smoking long before medical research could find the reason for this danger.
We are hearing much about epidemiology to understand the pandemic we are now suffering from as helping to understand what behavior leads to outbreaks of the disease and how the disease affects those who unfortunately get it. So much can be learned from going to the web under the heading “epidemiology of the COVID-19 pandemic.” The medical professionals are tuned into this ancient understanding of disease.