Past Conferences

International Society for Environmental Epidemiology 16th Annual Conference

The 16th Annual Conference of the International Society for Environmental Epidemiology was held on the Washington Square campus of New York University (NYU) at the new Kimmel Conference Center on August 1-4, 2004. The theme of the conference was "Addressing Urban Environmental Problems." The beautiful and relatively temperate weather (at least for New York in the summer) complemented the stunning setting of this meeting in the heart of New York's Greenwich Village, with panoramic views of many of New York's famous urban landmarks from the 10th floor Pavilion room atop the Kimmel Center. The conference hosted some 639 scientists and students.

This conference was generously supported by The U.S. Environmental Protection Agency, The National Institutes of Health (specifically, the National Institute of Environmental Health Sciences and the National Cancer Institute), The Centers for Disease Control and Prevention (specifically, the National Center for Environmental Health/Agency for Toxic Substances and Disease Registry), The Health Effects Institute, and The University of Medicine and Dentistry of New Jersey, for a total of $64,000. These funds were used for travel scholarships for scientists from developing countries and students and travel support for plenary speakers, as well as other meeting-related expenses. The Conference Co-Chairs were Drs. Dan Wartenberg of the University of Medicine and Dentistry of New Jersey's Robert Wood Johnson Medical School's Department of Environmental and Occupational Medicine and George Thurston of the Department of Environmental Medicine at the NYU School of Medicine.

The conference began with an opening session presenting an unprecedented two ISEE John Goldsmith Awards for outstanding contributions to environmental epidemiology. One award was presented in memory of Olav Axelson of Sweden's Karolinska Institute for his myriad of important contributions to the methodology and practice of environmental and occupational epidemiology. The other was presented to Aaron Blair of the USA's National Cancer Institute for his many and continuing contributions to the understanding and conduct of environmental and occupational epidemiology studies, with particular emphasis on pesticides and farm families.

Dr. Blair, as Sunday night's keynote speaker, presented some personal recollections of how he came to be an epidemiologist, and of some of his mentors, followed by a fascinating critique of the typical treatment of some common epidemiologic concerns, such as confounding, response bias, and causation. He made suggestions for ways to improve use of epidemiologic methods for the study and understanding of cause and effect relationships. This opening session was followed by a cocktail and hors d'oeuvres reception on the top floor of the Kimmel Center, with a piano accompaniment and a spectacular view of New York's nighttime skyline.

The formal ISEE 2004 meeting included three full days of technical sessions following the Sunday night opening session, with three ninety-minute plenary sessions (one each morning), 23 ninety-minute oral sessions, 22 ninety-minute poster/discussion sessions, and three all-day poster sessions. Five hundred seventy abstracts for the meeting were published in the July 2004 issue of Epidemiology (Vol. 15, No. 4), a copy of which was provided to all attendees. The abstracts are now also available on the ISEE website (www.iseepi.org). Abstracts were reviewed by two reviewers each, with an overall acceptance rate of approximately 95%. The abstract review process and the development of the program were coordinated by the Program Chair, Dr. Mort Lippmann of NYU, with the assistance of the Scientific Program Committee and the meeting co-chairs. Following the enthusiastic response to the experimental use of a limited number of poster/discussion sessions at previous ISEE meetings, the proportion of such sessions was increased to nearly 50%, to stimulate exciting and interactive discussions and to enable accommodation of a large number of presentations in the space and time available, while limiting the number of concurrent sessions to a maximum of five at any one time. Poster/discussion session chairs were provided with copies of the abstracts in their sessions ahead of time and asked to familiarize themselves with the abstracts and to prepare key questions that identified issues that crosscut the presentations and topics considered by their sessions. These sessions succeeded in promoting interesting and provocative interactions among presenters and between the presenters and the audience.

Monday morning's plenary session addressed, "Terrorism: The Role of Environmental Epidemiology in Detection, Assessment and Evaluation." Dr. Ed Kilbourne, Chief Medical Officer of the Center for Disease Control and Prevention's (CDC) National Center for Environmental Health opened the session with a fascinating discussion of how and why, following the tragedy of the September 11, 2001 attacks on the World Trade Center and the anthrax exposures that came in the weeks that followed, the CDC developed an effective rapid assessment and response capability and command center. He was followed by Dr. Farzad Mostashari, Assistant Commissioner of Health for the New York City Department of Health and Mental Hygiene (NYCDHMH), who described the computerized system developed at NYCDHMH for conducting near real-time syndromic surveillance, enabling rapid identification of unusual patterns of disease occurrences through assessment of surrogate information such as emergency room visits, hospitalizations, and pharmaceutical usage. The third speaker was Dr. Carol North, Professor of Psychiatry at the Washington University School of Medicine. Dr. North, drawing on her extensive experience with the bombing of the US Embassy in Nairobi, Kenya, the Oklahoma City bombing, the World Trade Center disaster, and the anthrax attacks on Capitol Hill, discussed the importance of mental health in understanding and responding to catastrophic events and the role of epidemiologic research in differentiating distress from psychiatric illness for effective preparation, response, and recovery. As if to highlight the urgency and importance of this session, on the day preceding the session the US Department of Homeland Security raised the national terrorism alert level to orange (the level just below the maximum red alert), and on the day of the session, the question and answer portion was interrupted and terminated by a fire alarm activation that forced evacuation of the entire Kimmel Center. Fortunately, no adverse events were identified and the meeting resumed for the morning technical sessions in a timely fashion.

Tuesday morning's plenary session addressed "An Environmental Epidemiological Perspective on the Health Consequences of Rapid Urban Growth in Developing Countries." Dr. Harry Caussy, of the World Health Organization's South East Asian Office in New Delhi, India, led off with a talk suggesting that urbanization increases the pressure for emergence of new strains of microorganisms, release of point source pollutants, and changes in personal lifestyles. While urbanization may be necessary for the growth and development of many nations, public health officials need to be aware of and respond to some of the associated consequences. Dr. Chien-Jen Chen, of National Taiwan University's College of Public Health, and Taiwan Health Minister, followed with a talk detailing some of the environmental diseases that have occurred in Taiwan during its transition from developing to developed country. These included the multiple serious health effects from exposure to arsenic in drinking water, such as heart disease, cancer, diabetes, and neurological disorders, the adverse impacts of indoor and outdoor air pollution, and the reproductive, developmental, and other consequences of using PCB-contaminated cooking oils. He concluded with a call for extensive monitoring, risk assessment, and management as an approach for minimizing the public health impact. Dr. Kuku Voyi, of South Africa's University of Pretoria School of Health Systems and Public Health, and the chair of ISEE's 2005 annual meeting, presented a stark overview of the public health issues in Africa, particularly sub-Saharan Africa. Many of the diseases that are having a major impact in this part of the world are ones that are being far better addressed in the developed world, such as HIV/AIDS, malaria, and tuberculosis, in addition to the diseases common in the developed world, such as heart disease, cancer, and maternal and child health. All are exacerbated by the prevalence of poverty and hunger in Africa. Noting that environmental health is only one of many serious issues currently confronting Africa, Dr. Voyi cited the key challenges as prioritizing issues and strategies and turning knowledge into action.

Wednesday morning's plenary session addressed "Scientific Integrity in Policymaking: An Epidemiologic Perspective." The session began with the presentation of ISEE's Research Integrity Award to Fernanda Giannasi, a worker advocate and founder of the Brazilian Victims Association, who was outraged by industry's disregard for the known health effects of exposure of workers to asbestos and fought for worker rights and for a total ban on asbestos imports and use in Brazil and Latin America. Fernanda has pointed out that this is a fight for environmental justice, getting the multinational companies to use the same worker safety practices in Brazil that they use in their own countries. Starting from scratch, she amassed an organization of 1,200 former workers, all concerned about their health and their former work practices. Sixty percent have been diagnosed with some type of asbestos-related illness. During her work on this issue, she has been harassed, charged with criminal defamation, and even received death threats. The fight continues. Unfortunately, due to a family illness, she was unable to attend the ISEE conference. Dr. Barry Castleman, a friend and supporter in the US, accepted the award on her behalf and presented a brief video recounting Fernanda's heroic efforts. This was followed by some additional remarks by Dr. Castleman, addressing some of his views on determinants of the global market for toxics, dangerous products, and discredited technologies, with a particular emphasis on asbestos.

Dr. David Michaels, Research Professor in the Department of Environmental and Occupational Health at the George Washington University and former Assistant Secretary of Energy for Environment, Safety and Health (1998-2001), was the next plenary speaker in this session. He spoke about some of the policies of the current US Government that may challenge the integrity of scientific research. This includes concerns about a controversial "peer-review" policy put forth by the Office of Management and Budget (OMB) that sought to restrict government release of scientific data until formal peer review. Some believe that this may delay the release of important health protective information at a time when precautionary and protective actions and policies could be implemented conditionally prior to the availability of more thorough scientific information. Without this OMB policy, others believe overly cautious policies could be implemented at increased cost to industry.

The final speaker was Dr. Anthony Robbins, Professor and Chair of Environmental and Community Health at the Tufts University School of Medicine, Co-Editor of the Journal of Public Health Policy, former Director of the US National Institute for Occupational Safety and Health, Commissioner of the Vermont State Health Department, and Executive Director of the Colorado Department of Health. Dr. Robbins spoke about how the current US government has undermined the scientific credibility of some of the most important and prestigious federal review and advisory committees. All government science seems under attack. In a manner unprecedented in this country, the scientific community has joined together to oppose a US President's science policies.

The technical sessions spanned the wide breadth of substantive areas of interest to ISEE members. Overall, there were 45 technical sessions, 15 per day presented in three separate time periods of five sessions each. Where possible, sessions were grouped into tracks of consecutive sessions on related topics. For example, each day there were three consecutive sessions on air pollution, with Monday's ranging from air quality in Europe to studies on particulate matter to studies on cardiac variability. Tuesday's air pollution track included modeling air pollution and weather, traffic effects, and health effects of specific air pollutants. Wednesday's included air pollution and pregnancy/infant health, childhood asthma, and the ARIES project. Another track focused on spatial analysis, including sessions on disease clusters, spatial exposure assessment, and the use of GIS for the study of health outcomes. Pesticide health effects were discussed in several sessions, as were the health effects of hazardous substances. Another of Monday's set of consecutive sessions addressed climate change issues, including urban heat waves and climate modeling scenarios. Sessions on heavy metals looked at the health effects of exposure to arsenic, mercury, and lead. Sessions on water discussed recreational water use, disinfection by-products, and the impact of nitrates in drinking water. Additional sessions considered environmental oncology, disasters, Parkinson's disease, biomarkers of disease and exposure, epidemiologic methods, childhood asthma, environmental public health tracking, the microelectronics industry, occupational health, mass violence, terror and war, environmental policy, the precautionary principle, genetic susceptibility, risk communication, socioeconomic status and health, urbanization and cancer, and endocrine disruptors. All sessions were well attended, including the last sessions on Wednesday afternoon, which were followed by a farewell cocktail party that was attended by more than 100 of the attendees.

Recreational events were also held on Monday and Tuesday evening. Monday night activities included a dinner cruise around Manhattan Island with live entertainment. The cruise toured many of New York's water-based sights, such as the Statue of Liberty, Governor's Island, Ellis Island, and the famed Brooklyn Bridge. The cruise was included in the registration fee, which made the event more inclusive than if it were charged as a separate fee. Some 550 registrants and guests participated in the trip (even though rebates were offered for those who chose not to go). The clear and mild weather that evening contributed to an enjoyable cruise. Tuesday night included the showing of a stunning film, Future Conditional, by Emmy Award winning producers Hal and Marilyn Weiner. The film is a global investigation of the link between the spread of toxic pollution and the health of our planet, including segments on Artic wildlife, tariff-free factories along the Mexican border, and the impending demise of California's Aral Sea. Following this, there was a reception for researchers interested in studying air pollution and public health in Asia, sponsored by the Health Effects Institute, and optional side trips to see New York Yankees baseball or theater performances on Broadway.

The meeting attracted registrants from 36 different countries, including more than 100 students and many scientists from developing countries. Attendees were from the USA (374), United Kingdom (29), Canada (21), Taiwan (19), France (17), Germany (17), Mexico (13), The Netherlands (12), Italy (11), South Korea (11), Australia (9), Spain (8), and Israel (7). Other countries represented included Argentina, Brazil, Bulgaria, Czech Republic, Chile, China (People's Republic), Denmark, Finland, Hungary, India, Ireland, Japan, Lithuania, Malaysia, New Zealand, Norway, Poland, Slovak Republic, South Africa, Sweden, Switzerland, Trinidad and Tobago, and Turkey. Because the (higher) registration fee for non-members included a one-year membership to ISEE, the high attendance at this meeting led to the addition more than 150 new members to ISEE and more than 40 membership renewals.

To assist those with limited travel budgets in attending the meeting, particularly scientists from developing countries and students, 44 travel grants were offered, for a total of more than $42,000. Thirty-three delegates were able to take advantage of these awards, at a total value of more than $30,000. Additional travel expenses for plenary speakers were paid in part by ISEE ($10,000) and in part through the generosity of some of their employers.

We included in participants' conference registration packets an evaluation form. The form consisted mostly of quantitative questions on the content and logistics of the conference, with room for specific comments. Unfortunately, as is common at such meetings, the response rate was low, about 10% in this case. Attendees were asked to evaluate aspects of the conference on a six-point scale, from Excellent (6,5) to Good (4,3) to Poor (2,1). Nearly all scores were excellent. The overall conference received a score of 4.7 (met expectations at 4.9), the subject matter a 5.1, and program content a 4.8. The plenaries received an average score of 4.4, and the scores for the individual sessions were quite varied but generally had too few responses to be reliable. More than half of the respondents wanted more oral sessions but the same number of discussion sessions and poster sessions, an interesting challenge for future meeting organizers. Respondents were enthusiastic about the city venue, and also New York in particular, and greatly appreciated the hospitality services. The various food venues each scored between 4.5 and 5.0, and the cruise (banquet/entertainment) scored an amazing 5.6 out of 6.

Overall, the meeting was a great success in terms of the quality of scientific presentations and interactions, ISEE member recruitment, financial outcome, and the fun attendees had with their brief experiences in New York, a city claimed by some to be the most exciting in the world.

Submitted by Daniel Wartenberg, PhD

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