Day 031 - 05 Oct 94 - Page 20


     
     1
     2   Q.   But that would be because?
     3        A.  Because of the evidence that we have, yes.
     4
     5   Q.   That there is -----
     6        A.  The sum total of the evidence.
     7
     8   Q.   That there is a risk that ----?
     9        A.  Yes.  A possible risk that you would do those children
    10        on the high saturated fat diet serious injury in one way
    11        or another.
    12
    13   Q.   The reliability of epidemiological evidence has been
    14        criticised.  It has been said that it suffers from
    15        deficiencies.  You have argued against that in your
    16        statement?
    17        A.  Yes.
    18
    19   Q.   Is that something that is from personal experience?
    20        A.  Well, yes.  I have worked with the World Health
    21        Organisation on several international projects and I have
    22        had first hand experience of how some of this data is
    23        collected.  Yes, the data has a degree of unreliability
    24        about it.  All data is unreliable and, to a certain
    25        extent, we have to go to the extent of atomic clocks to
    26        know what the real time is.  It is really a question of
    27        the degree of unreliability.
    28
    29        What I was trying to express here was that the degree of
    30        reliability is certainly good enough for the purposes of
    31        making judgments from the epidemiological evidence.  The
    32        personal experience we had in Uganda, when I was working
    33        there, was very clear, not just the reliability of the
    34        international evidence but the reliability of the evidence
    35        within Uganda was sufficient for Burkitt to discover the
    36        relationship between a virus and Burkitt's Lymphoma (which
    37        carries his name) for us to identify a high presence of a
    38        potential carcinogen in the diet of people in Uganda.
    39
    40        I think the criticism on the unreliability of evidence in
    41        developing countries is somewhat over done because the
    42        people who collect this kind of evidence know what is
    43        happening there.  In Uganda you simply do not have breast
    44        cancer.  It is not a story.  You do not have colon
    45        cancer.  You have other problems.  You have volvulus,
    46        endomyocardial fibrosis but you do not have heart disease,
    47        cardiovascular disease as we know it.  I think it is
    48        probably wise, when talking of cancer, to remember that we
    49        are not talking about all cancers, because in Uganda we
    50        have primary carcinoma of the liver.  This is really quite 
    51        common, but we do not see primary carcinoma of the liver 
    52        in northern Europe. 
    53
    54   MR. JUSTICE BELL:  If you look at the first paragraph under
    55        "Reliability of epidemiological evidence", can you give
    56        me an example -- it is probably not much use going to
    57        Uganda over cancer of the breast and colon in the light of
    58        what you have just said -- of how first hand knowledge of
    59        local health would flag a serious discrepancy, so I can
    60        see what you mean by that?

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