TORTINI

For your delectation and delight, desultory dicta on the law of delicts.

Tremolitic Tergiversation or Ex-PIRG-Gation?

August 11th, 2018

My first encounter with the Public Interest Research Group (PIRG) was as an undergraduate when my college mandated that part of the student activity fee went to New Jersey PIRG. The college administration gave students no choice in the matter.

Upon investigating PIRG’s activities and rhetoric, I found the organization filled with self-aggrandizement, and puffed out with a self-satisfied arrogance. Epistemically, politically, and historically, an organization that declared all its goals to be “in the public interest” was jarring and objectionable, but it was probably just my own idiosyncratic sensitivity.

Many of my fellow students and I protested the forced support for PIRG, and ultimately the college yielded to the tide of opinion. Students were give a choice to opt out of paying the portion of their fees that went to PIRG.

Almost 50 years later, I still have a healthy skepticism of most self-proclaimed “public interest” groups, including PIRG. And so, my antennae went up upon seeing a New York Times article about a PIRG back-to-school shopping guide, with warnings about hazardous materials in crayons and magic markers. See Niraj Chokshi, “Asbestos in a Crayon, Benzene in a Marker: A School Supply Study’s Toxic Results,” N.Y. Times (Aug. 8, 2018). The hazard lurking in crayons, according to PIRG, was none other than the emperor of all toxic substances: asbestos. The Times dutifully reported that PIRG had found only “trace” tremolite, but the newspaper made no attempt to quantify the amount found; nor did the paper describe the meaninfulness of inhalational exposure from trace amount of tremolite embedded in wax. Instead, the Times reported a worrisome quote: “Tremolite is responsible for many cases of asbestos-related cancer and asbestos diseases, according to the Abramson Cancer Center at the University of Pennsylvania.”

* * * * * * * * * * *

A thing is a phallic symbol if it is longer than it is wide.” 

Melanie, Safka (1972)

A thing is a fiber if it is three times longer than it is wide.” 

O.S.H.A., 29 C.F.R. § 1910.1001(b) (defining fiber as having a length-to- diameter ratio of at least 3 to 1).

Ergo, all fibers are phallic symbols.

* * * * * * * * * * *

The New York Times article did link to PIRG’s report, which at least allowed readers to inspect the inculpatory evidence. U.S. PIRG, Safer School Supplies: Shopping Guide: Consumer Guide for Finding Non-Toxic School Supplies (2018). Unfortunately, the PIRG report did not answer crucial questions. There was no quantification of the tremolite asbestos, and there was no discussion of the ability of the tremolite to escape the wax matrix of the crayon, to become airborne, and to be inhaled. The report did cite the methodology used to ascertain the presence of the tremolite (EPA Method: EPA/600/R-93/116). Safer Schools at 5. In Appendix A to the report, the authors showed two microphotographs of tremolite particles, but without any measurement scale. One of the two tremolite particles looks like a cleavage fragment, not a fiber. The other photomicrograph shows something that might be a fiber, but without a scale and a report of the elemental peaks, the reader cannot tell for sure. Safer Schools at 21.

The controversy over the potential health effects of tremolite cleavage fragments has a long history. Compare Robert Reger & W. Keith C. Morgan, “On talc, tremolite, and tergiversation,” 47 Brit. J. Indus. Med. 505 (1990) with Bruce W. Case, “On talc, tremolite, and tergiversation. Ter-gi-ver-sate: 2: to use subterfuges,” 48 Brit. J. Indus. Med. 357 (1991). The regulatory definition of fiber does not distinguish between biologically significant fibers and particles with an aspect ratio greater than three. John Gamble & Graham Gibbs, “An evaluation of the risks of lung cancer and mesothelioma from exposure to amphibole cleavage fragments,” 52 Regulatory Toxicol. & Pharmacol. S154 (2008) (the weight of evidence fully supports a conclusion that non-asbestiform amphiboles do not increase the risk of lung cancer or mesothelioma); Brent L. Finley, Stacey M. Benson & Gary M. Marsh, “Cosmetic talc as a risk factor for pleural mesothelioma: a weight of evidence evaluation of the epidemiology,” 29 Inhalation Toxicol. 179 (2017).

Surely the public interest includes the facts and issues left out by PIRG’s report.

 

 

N.J. Supreme Court Uproots Weeds in Garden State’s Law of Expert Witnesses

August 8th, 2018

The United States Supreme Court’s decision in Daubert is now over 25 years old. The idea of judicial gatekeeping of expert witness opinion testimony is even older in New Jersey state courts. The New Jersey Supreme Court articulated a reliability standard before the Daubert case was even argued in Washington, D.C. See Landrigan v. Celotex Corp., 127 N.J. 404, 414 (1992); Rubanick v. Witco Chem. Corp., 125 N.J. 421, 447 (1991). Articulating a standard, however, is something very different from following a standard, and in many New Jersey trial courts, until very recently, the standard was pretty much anything goes.

One counter-example to the general rule of dog-eat-dog in New Jersey was Judge Nelson Johnson’s careful review and analysis of the proffered causation opinions in cases in which plaintiffs claimed that their use of the anti-acne medication isotretinoin (Accutane) caused Crohn’s disease. Judge Johnson, who sits in the Law Division of the New Jersey Superior Court for Atlantic County held a lengthy hearing, and reviewed the expert witnesses’ reliance materials.1 Judge Johnson found that the plaintiffs’ expert witnesses had employed undue selectivity in choosing what to rely upon. Perhaps even more concerning, Judge Johnson found that these witnesses had refused to rely upon reasonably well-conducted epidemiologic studies, while embracing unpublished, incomplete, and poorly conducted studies and anecdotal evidence. In re Accutane, No. 271(MCL), 2015 WL 753674, 2015 BL 59277 (N.J.Super. Law Div., Atlantic Cty. Feb. 20, 2015). In response, Judge Johnson politely but firmly closed the gate to conclusion-driven duplicitous expert witness causation opinions in over 2,000 personal injury cases. “Johnson of Accutane – Keeping the Gate in the Garden State” (Mar. 28, 2015).

Aside from resolving over 2,000 pending cases, Judge Johnson’s judgment was of intense interest to all who are involved in pharmaceutical and other products liability litigation. Judge Johnson had conducted a pretrial hearing, sometimes called a Kemp hearing in New Jersey, after the New Jersey Supreme Court’s opinion in Kemp v. The State of New Jersey, 174 N.J. 412 (2002). At the hearing and in his opinion that excluded plaintiffs’ expert witnesses’ causation opinions, Judge Johnson demonstrated a remarkable aptitude for analyzing data and inferences in the gatekeeping process.

When the courtroom din quieted, the trial court ruled that the proffered testimony of Dr., Arthur Kornbluth and Dr. David Madigan did not meet the liberal New Jersey test for admissibility. In re Accutane, No. 271(MCL), 2015 WL 753674, 2015 BL 59277 (N.J.Super. Law Div. Atlantic Cty. Feb. 20, 2015). And in closing the gate, Judge Johnson protected the judicial process from several bogus and misleading “lines of evidence,” which have become standard ploys to mislead juries in courthouses where the gatekeepers are asleep. Recognizing that not all evidence is on the same analytical plane, Judge Johnson gave case reports short shrift.

[u]nsystematic clinical observations or case reports and adverse event reports are at the bottom of the evidence hierarchy.”

Id. at *16. Adverse event reports, largely driven by the very litigation in his courtroom, received little credit and were labeled as “not evidentiary in a court of law.” Id. at 14 (quoting FDA’s description of FAERS).

Judge Johnson recognized that there was a wide range of identified “risk factors” for irritable bowel syndrome, such as prior appendectomy, breast-feeding as an infant, stress, Vitamin D deficiency, tobacco or alcohol use, refined sugars, dietary animal fat, fast food. In re Accutane, 2015 WL 753674, at *9. The court also noted that there were four medications generally acknowledged to be potential risk factors for inflammatory bowel disease: aspirin, nonsteroidal anti-inflammatory medications (NSAIDs), oral contraceptives, and antibiotics. Understandably, Judge Johnson was concerned that the plaintiffs’ expert witnesses preferred studies unadjusted for potential confounding co-variables and studies that had involved “cherry picking the subjects.” Id. at *18.

Judge Johnson had found that both sides in the isotretinoin cases conceded the relative unimportance of animal studies, but the plaintiffs’ expert witnesses nonetheless invoked the animal studies in the face of the artificial absence of epidemiologic studies that had been created by their cherry-picking strategies. Id.

Plaintiffs’ expert witnesses had reprised a common claimants’ strategy; namely, they claimed that all the epidemiology studies lacked statistical power. Their arguments often ignored that statistical power calculations depend upon statistical significance, a concept to which many plaintiffs’ counsel have virulent antibodies, as well as an arbitrarily selected alternative hypothesis of association size. Furthermore, the plaintiffs’ arguments ignored the actual point estimates, most of which were favorable to the defense, and the observed confidence intervals, most of which were reasonably narrow.

The defense responded to the bogus statistical arguments by presenting an extremely capable clinical and statistical expert witness, Dr. Stephen Goodman, to present a meta-analysis of the available epidemiologic evidence.

Meta-analysis has become an important facet of pharmaceutical and other products liability litigation[1]. Fortunately for Judge Johnson, he had before him an extremely capable expert witness, Dr. Stephen Goodman, to explain meta-analysis generally, and two meta-analyses he had performed on isotretinoin and irritable bowel outcomes.

Dr. Goodman explained that the plaintiffs’ witnesses’ failure to perform a meta-analysis was telling when meta-analysis can obviate the plaintiffs’ hyperbolic statistical complaints:

the strength of the meta-analysis is that no one feature, no one study, is determinant. You don’t throw out evidence except when you absolutely have to.”

In re Accutane, 2015 WL 753674, at *8.

Judge Johnson’s judicial handiwork received non-deferential appellate review from a three-judge panel of the Appellate Division, which reversed the exclusion of Kornbluth and Madigan. In re Accutane Litig., 451 N.J. Super. 153, 165 A.3d 832 (App. Div. 2017). The New Jersey Supreme Court granted the isotretinoin defendants’ petition for appellate review, and the issues were joined over the appropriate standard of appellate review for expert witness opinion exclusions, and the appropriateness of Judge Johnson’s exclusions of Kornbluth and Madigan. A bevy of amici curiae joined in the fray.2

Last week, the New Jersey Supreme Court issued a unanimous opinion, which reversed the Appellate Division’s holding that Judge Johnson had “mistakenly exercised” discretion. Applying its own precedents from Rubanick, Landrigan, and Kemp, and the established abuse-of-discretion standard, the Court concluded that the trial court’s ruling to exclude Kornbluth and Madigan was “unassailable.” In re Accutane Litig., ___ N.J. ___, 2018 WL 3636867 (2018), Slip op. at 79.3

The high court graciously acknowledged that defendants and amici had “good reason” to seek clarification of New Jersey law. Slip op. at 67. In abandoning abuse-of-discretion as its standard of review, the Appellate Division had relied upon a criminal case that involved the application of the Frye standard, which is applied as a matter of law. Id. at 70-71. The high court also appeared to welcome the opportunity to grant review and reverse the intermediate court reinforce “the rigor expected of the trial court” in its gatekeeping role. Id. at 67. The Supreme Court, however, did not articulate a new standard; rather it demonstrated at length that Judge Johnson had appropriately applied the legal standards that had been previously announced in New Jersey Supreme Court cases.4

In attempting to defend the Appellate Division’s decision, plaintiffs sought to characterize New Jersey law as somehow different from, and more “liberal” than, the United States Supreme Court’s decision in Daubert. The New Jersey Supreme Court acknowledged that it had never formally adopted the dicta from Daubert about factors that could be considered in gatekeeping, slip op. at 10, but the Court went on to note what disinterested observers had long understood, that the so-called Daubert factors simply flowed from a requirement of sound methodology, and that there was “little distinction” and “not much light” between the Landrigan and Rubanick principles and the Daubert case or its progeny. Id at 10, 80.

Curiously, the New Jersey Supreme Court announced that the Daubert factors should be incorporated into the New Jersey Rules 702 and 703 and their case law, but it stopped short of declaring New Jersey a “Daubert” jurisdiction. Slip op. at 82. In part, the Court’s hesitance followed from New Jersey’s bifurcation of expert witness standards for civil and criminal cases, with the Frye standard still controlling in the criminal docket. At another level, it makes no sense to describe any jurisdiction as a “Daubert” state because the relevant aspects of the Daubert decision were dicta, and the Daubert decision and its progeny were superseded by the revision of the controlling statute in 2000.5

There were other remarkable aspects of the Supreme Court’s Accutane decision. For instance, the Court put its weight behind the common-sense and accurate interpretation of Sir Austin Bradford Hill’s famous articulation of factors for causal judgment, which requires that sampling error, bias, and confounding be eliminated before assessing whether the observed association is strong, consistent, plausible, and the like. Slip op. at 20 (citing the Reference Manual at 597-99), 78.

The Supreme Court relied extensively on the National Academies’ Reference Manual on Scientific Evidence.6 That reliance is certainly preferable to judicial speculations and fabulations of scientific method. The reliance is also positive, considering that the Court did not look only at the problematic epidemiology chapter, but adverted also to the chapters on statistical evidence and on clinical medicine.

The Supreme Court recognized that the Appellate Division had essentially sanctioned an anything goes abandonment of gatekeeping, an approach that has been all-too-common in some of New Jersey’s lower courts. Contrary to the previously prevailing New Jersey zeitgeist, the Court instructed that gatekeeping must be “rigorous” to “prevent[] the jury’s exposure to unsound science through the compelling voice of an expert.” Slip op. at 68-9.

Not all evidence is equal. “[C]ase reports are at the bottom of the evidence hierarchy.” Slip op. at 73. Extrapolation from non-human animal studies is fraught with external validity problems, and such studies “far less probative in the face of a substantial body of epidemiologic evidence.” Id. at 74 (internal quotations omitted).

Perhaps most chilling for the lawsuit industry will be the Supreme Court’s strident denunciation of expert witnesses’ selectivity in choosing lesser evidence in the face of a large body of epidemiologic evidence, id. at 77, and their unprincipled cherry picking among the extant epidemiologic publications. Like the trial court, the Supreme Court found that the plaintiffs’ expert witnesses’ inconsistent use of methodological criteria and their selective reliance upon studies (disregarding eight of the nine epidemiologic studies) that favored their task masters was the antithesis of sound methodology. Id. at 73, citing with approval, In re Lipitor, ___ F.3d ___ (4th Cir. 2018) (slip op. at 16) (“Result-driven analysis, or cherry-picking, undermines principles of the scientific method and is a quintessential example of applying methodologies (valid or otherwise) in an unreliable fashion.”).

An essential feature of the Supreme Court’s decision is that it was not willing to engage in the common reductionism that has “all epidemiologic studies are flawed,” and which thus privileges cherry picking. Not all disagreements between expert witnesses can be framed as differences in interpretation. In re Accutane will likely stand as a bulwark against flawed expert witness opinion testimony in the Garden State for a long time.


1 Judge Nelson Johnson is also the author of Boardwalk Empire: The Birth, High Times, and Corruption of Atlantic City (2010), a spell-binding historical novel about political and personal corruption.

2 In support of the defendants’ positions, amicus briefs were filed by the New Jersey Business & Industry Association, Commerce and Industry Association of New Jersey, and New Jersey Chamber of Commerce; by law professors Kenneth S. Broun, Daniel J. Capra, Joanne A. Epps, David L. Faigman, Laird Kirkpatrick, Michael M. Martin, Liesa Richter, and Stephen A. Saltzburg; by medical associations the American Medical Association, Medical Society of New Jersey, American Academy of Dermatology, Society for Investigative Dermatology, American Acne and Rosacea Society, and Dermatological Society of New Jersey, by the Defense Research Institute; by the Pharmaceutical Research and Manufacturers of America; and by New Jersey Civil Justice Institute. In support of the plaintiffs’ position and the intermediate appellate court’s determination, amicus briefs were filed by political action committee the New Jersey Association for Justice; by the Ironbound Community Corporation; and by plaintiffs’ lawyer Allan Kanner.

3 Nothing in the intervening scientific record called question upon Judge Johnson’s trial court judgment. See, e.g., I.A. Vallerand, R.T. Lewinson, M.S. Farris, C.D. Sibley, M.L. Ramien, A.G.M. Bulloch, and S.B. Patten, “Efficacy and adverse events of oral isotretinoin for acne: a systematic review,” 178 Brit. J. Dermatol. 76 (2018).

4 Slip op. at 9, 14-15, citing Landrigan v. Celotex Corp., 127 N.J. 404, 414 (1992); Rubanick v. Witco Chem. Corp., 125 N.J. 421, 447 (1991) (“We initially took that step to allow the parties in toxic tort civil matters to present novel scientific evidence of causation if, after the trial court engages in rigorous gatekeeping when reviewing for reliability, the proponent persuades the court of the soundness of the expert’s reasoning.”).

5 The Court did acknowledge that Federal Rule of Evidence 702 had been amended in 2000, to reflect the Supreme Court’s decision in Daubert, Joiner, and Kumho Tire, but the Court did not deal with the inconsistencies between the present rule and the 1993 Daubert case. Slip op. at 64, citing Calhoun v. Yamaha Motor Corp., U.S.A., 350 F.3d 316, 320-21, 320 n.8 (3d Cir. 2003).

6 See Accutane slip op. at 12-18, 24, 73-74, 77-78. With respect to meta-analysis, the Reference Manual’s epidemiology chapter is still stuck in the 1980s and the prevalent resistance to poorly conducted, often meaningless meta-analyses. SeeThe Treatment of Meta-Analysis in the Third Edition of the Reference Manual on Scientific Evidence” (Nov. 14, 2011) (The Reference Manual fails to come to grips with the prevalence and importance of meta-analysis in litigation, and fails to provide meaningful guidance to trial judges).

Two Stanford Researchers Are Anti-Semantic

August 4th, 2018

Two Stanford University communications researchers have shown that fraudulent publications and authors’ linguistic obfuscation are correlated, p < 0.05. David M. Markowitz & Jeffrey T. Hancock, “Linguistic Obfuscation in Fraudulent Science,” 35 J. Language & Social Psych. 435 (2016); Bjorn Carey, “Stanford researchers uncover patterns in how scientists lie about their data,Stanford Report (Nov. 16, 2015) [Carey, below]

Stanford Professor of Communication, Jeff Hancock, and graduate student David Markowitz observed that there are repeating patterns of expression in the language used by scientific fraudfeasors. They hypothesized that scientific fraudfeasors would signal their duplicity in their linguistic expressions as well. These authors created a linguistic obfuscation index based upon the prevalence of jargon, abstraction, positive emotion terms, and readability. They then compared the obfuscation index scores of 253 papers retracted for fraudulent data with 253 unretracted papers, and 63 papers retracted for reasons other than fraud. Not surprisingly, Hancock and Markowitz found differences, with fraudulent papers having higher obfuscation scores, and generally more jargon.

As Markowitz explained:

We believe the underlying idea behind obfuscation is to muddle the truth. *** Scientists faking data know that they are committing a misconduct and do not want to get caught. Therefore, one strategy to evade this may be to obscure parts of the paper. We suggest that language can be one of many variables to differentiate between fraudulent and genuine science.”

Carey. Professor Hancock acknowledged that there remained a high error rate in their obfuscation analysis, which needed to be lowered before automatic linguistic analyses could be useful for detecting fraud. Hancock also acknowledged that such the use of such a computerized linguistic tool might undermine the trust upon which science is based. Id.

Well detecting fraud might undermine trust, but look where trust has gotten us in science.

Trust but verify.

I cannot wait until I proffer the first expert witness rebuttal report in litigation, to show that my adversary’s expert witness has crossed the obfuscation line.

From Here to CERT-ainty

June 28th, 2018

An enterprising journalist, Michael Waters, recently published an important exposé on the Council for Education and Research on Toxics (CERT). Michael Waters, “The Secretive Non-Profit Gaming California’s Health Laws: The Council for Education and Research on Toxics has won million-dollar settlements using a controversial public health law,” The Outline (June 18, 2018). Digging deep into the shadowy organization, Mr. Waters reported that:

“CERT doesn’t have a website, a social media account, or any notable public presence, despite having won million-dollar judgments by suing corporations. However, files from the California Secretary of State show that in May 30, 2001, four people co-founded the non-profit: C. Sterling Wolfe, a former environmental lawyer; Brad Lunn; Carl Cranor, a toxicology professor at University of California Riverside; and Martyn T. Smith, a toxicology professor at Berkeley.”

Id.

Mr. Water’s investigation puts important new facts on the table about the conduct of the CERT corporation. The involvement of Christopher Sterling Wolfe, a Torrance, California, plaintiffs’ lawyer, is not terribly surprising. The involvement in CERT of frequent plaintiffs’ expert witnesses, Carl F. Cranor and Martyn T. Smith, however, raises serious ethical questions. Both Cranor and Smith were expert witnesses for plaintiffs in the infamous Milward case,1 and after the trial court excluded their testimony and granted summary judgment, CERT filed an amicus brief in the Court of Appeals.2

The rules governing amicus briefs in federal appellate courts require disclosure of the amicus’s interest in the proceedings. By the time that CERT filed its amicus brief in Milward, Cranor and Smith may not have been officers of the corporation, but given CERT’s funding of Smith’s research, these “Founding Fathers” certainly had a continuing close relationship with the corporation.3Coffee with Cream, Sugar & a Dash of Acrylamide” (June 9, 2018). Given CERT’s name, which suggests a public interest mission, the corporation’s litigation activities on behalf of its founders, Cranor and Smith, exhibit a certain lack of candor with the court.

======================

My discussions with Mr. Waters, and his insightful piece in The Outline, led to a call from Madeleine Brand, who wanted to discuss CERT’s litigation against Starbucks, under California’s Proposition 65 laws, over acrylamide content in coffee. David Roe, a self-styled environmental activist and drafter of California’s bounty hunting law, was interviewed directly after me.4

As every California now no doubt knows, acrylamide is present in many foods. The substance is created when the amino acid asparagine is heated in the presence of sugars. Of course, I expected to hear Roe defend his creation, Proposition 65, generally, and the application of Proposition 65 to the low levels of acrylamide in coffee, perhaps on contrary-to-fact precautionary principle grounds. What surprised me were Roe’s blaming the victim, Starbucks for not settling, and his strident assertions that it was a long-established fact that acrylamide causes cancer.

Contrary to Roe’s asseverations, the National Cancer Institute has evaluated the acrylamide issues quite differently. On its website, the NCI has addressed “Acrylamide and Cancer Risk,” and mostly found none. Roe had outrageously suggested that there were no human data, because of the ethics of feeding acrylamide to humans, and so regulators had to rely upon rodent studies. The NCI, however, had looked at occupational studies in which workers were exposed to acrylamide in manufacturing processes at levels much higher than any dietary intake. The NCI observed “studies of occupational exposure have not suggested increased risks of cancer.” As for rodents, the NCI noted that “toxicology studies have shown that humans and rodents not only absorb acrylamide at different rates, they metabolize it differently as well.”

The NCI’s fact sheet is a relatively short précis, but the issue of acrylamide has been addressed in many studies, collected and summarized in meta-analyses.5 Since the NCI’s summary of the animal toxicology and human epidemiology, several important research groups have reported careful human studies that consistently have found no association between dietary acrylamide and cancer risk.6


1 Milward v. Acuity Specialty Products Group, Inc., 639 F.3d 11 (1st Cir. 2011), cert. denied sub nom., U.S. Steel Corp. v. Milward, 132 S. Ct. 1002 (2012).

2 See “The Council for Education and Research on Toxics” (July 9, 2013).

3 A Guidestar Report show that in 2007, the corporate officer were Nancy L. Quam-Wickham and Nancy Perley, in addition to Lunn and Wolfe.

4 Not to be confused with David Roe, the famous snooker player.

5 Claudio Pelucchi, Carlo La Vecchia, Bosetti C, P. Boyle & Paolo Boffetta, “Exposure to acrylamide and human cancer–a review and meta-analysis of epidemiologic studies,” 22 Ann. Oncology 1487 (2011); Claudio Pelucchi, Cristina Bosetti, Carlotta Galeone & Carlo La Vecchia, “Dietary acrylamide and cancer risk: An updated meta-analysis,” 136 Internat’l J. Cancer 2912 (2015).

6 C. Pelucchi, V. Rosato, P. M. Bracci, D. Li, R. E. Neale, E. Lucenteforte, D. Serraino, K. E. Anderson, E. Fontham, E. A. Holly, M. M. Hassan, J. Polesel, C. Bosetti, L. Strayer, J. Su, P. Boffetta, E. J. Duell & C. La Vecchia, “Dietary acrylamide and the risk of pancreatic cancer in the International Pancreatic Cancer Case–Control Consortium (PanC4),” 28 Ann. Oncology 408 (2017) (reporting that the PanC4 pooled-analysis found no association between dietary acrylamide and pancreatic cancer); Rebecca E. Graff, Eunyoung Cho, Mark A. Preston, Alejandro Sanchez, Lorelei A. Mucci & Kathryn M. Wilson, “Dietary acrylamide intake and risk of renal cell carcinoma in two large prospective cohorts,” 27 Cancer Epidemiol., Biomarkers & Prevention (2018) (in press at doi: 10.1158/1055-9965.EPI-18-0320) (failing to find an association between dietary acrylamide and renal cell carcinoma); Andy Perloy, Leo J. Schouten, Piet A. van den Brandt, Roger Godschalk, Frederik-Jan van Schooten & Janneke G. F. Hogervorst, “The Role of Genetic Variants in the Association between Dietary Acrylamide and Advanced Prostate Cancer in the Netherlands Cohort Study on Diet and Cancer,” 70 Nutrition & Cancer 620 (2018) (finding “no clear evidence was found for interaction between acrylamide intake and selected genetic variants for advanced prostate cancer”).

The opinions, statements, and asseverations expressed on Tortini are my own, or those of invited guests, and these writings do not necessarily represent the views of clients, friends, or family, even when supported by good and sufficient reason.