Dan Fagin, winner of the 2014 Pulitzer Prize for General Nonfiction for his book, “Toms River: A Story of Science and Salvation” (Bantam, 2013), delivered the Kaufman-Repage Lecture at Wagner College’s 2014 Founders Day Convocation on Wednesday, Oct. 8. This is the slideshow that accompanied Fagin's lecture (http://youtu.be/rPIiC2iBmTI).

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9. TToommss RRiivveerr
99

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14. 1144

15. 1155
John Snow William Farr

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17. TToommss RRiivveerr
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19. “Toms River had a moderately elevated SIR for all cancers
combined (49% higher) and leukemia (80% higher).
However, neither of these SIRs were statistically significant.
Brain and CNS cancer was more than three times higher
than expected for children under 20. For Toms River
children under five, brain and CNS cancer incidence was
significantly elevated, over seven times higher than
expected. All SIRs calculated for Dover Township were
higher than expected. Brain and CNS cancer in children
under five was more than two and one-half times higher
than expected, though not statistically significant…”
“Because of the small number of cases included in this
analysis, it is not possible to conduct studies to determine
possible causes at the municipality or even county level.”
-- Michael Barry, NJ State Dept. of Health
8/31/95 unreleased letter

23. Children prenatally exposed to Parkway Water 1982-96,
diagnosed with leukemia or CNS Cancers before age 20:
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Girls prenatally exposed to Parkway Water 1984-96, diagnosed
with leukemia before age 5 (birth records study):

25. “Although no associations were detected in analyses of the
overall study population, a statistically significant
association and consistency in multiple measures of
association were seen between prenatal exposure to time-specific
Parkway well field water (1982-1996) and leukemia
in female children of all ages.”
“Although no associations were detected in analyses of the
overall study population, a consistent elevation in the odds
ratios and an apparent dose response effect was seen in
both the Interview and Birth Records Studies between
prenatal exposure to Ciba-Geigy ambient air and leukemia
in female children diagnosed prior to age five.”

27. TToommss RRiivveerr 2277

32. What Now?
• Make peace with uncertainty in public health; epidemiology works.
• Capitalize on Big Data: $80 billion vs. $8 billion.
• Robust oversight, adequately funded. No more hollow agencies.
• Much more independent science, especially in regulatory decision-making.
• No more empty slogans and reflexive combat. Engage with evidence,
acknowledge uncertainty (again!), recognize tradeoffs.
• Important information cannot be contained in a digital world.
• As reach, influence of professional media declines, burden is on stakeholders
to provide context and be transparent about agendas. Shirk it at your peril.