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Society for
Epidemiologic Research (SER) Presidential Addresses
Michigan’s
Schottenfeld Gives SER Presidential Address
The 1999 SER Presidential
address was different. Unlike past presidents who have often chosen to
comment on the trends in epidemiology and the challenges facing the
profession, outgoing SER president David Schottenfeld
chose, instead, to focus the attention of epidemiologists on a
heretofore neglected area of research, namely the role of surgically
implanted medical devices in causing autoimmune diseases.
Schottenfeld took as his
starting point the silicone gel breast implant controversy. He
emphasized that epidemiologic research provides the essential
foundation of scientific evidence for liability cases and ultimately
influences public policy. Collectively, he stated, each peer-reviewed
epidemiologic publication contributes to a mosaic of information and
scientific consensus.
But Schottenfeld believes
research should now be focused on the more than 5% of the U.S.
population who have received various implanted devices other than a
breast implant (dental and facial implants, artificial joints, heart
valves, metallic fixation devices, pacemakers and others). What about
the safety of these devices? No one is talking about this, but
Schottenfeld wants to avoid a repeat of the frenzy surrounding the
breast implant situation caused by the failure to be pro-active in
looking at safety issues. He wants to stimulate more research now,
including the development of an operational definition for
undifferentiated connective tissue disease (UCTD). He noted how
existing paradigms guide the interpretation of a pattern of
observations, and he called for a change in our existing paradigms to
look at the effects of other implant devices. Schottenfeld has been
active in this research field having published in April of this year
in the American Journal of Epidemiology and having another paper
currently undergoing peer review. The AJE paper “Petroleum Distillate
Solvents as Risk Factors for Undifferentiated Connective Tissue
Disease” (UCTD), 1999, Volume 149, 761 - 70) found that
exposure to petroleum distillates such as paint thinners or removers
and mineral spirits increased the risk of developing UCTD.
Schottenfeld believes that the study of other potential "environmental
triggers" of UCTD is overdue and would be a productive area of
inquiry.
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