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Presentation at Court hearings 26 August 2003 

This is Rylander’s summary, delivered to the Court in Geneva during the final hearing. It is a critical review of the evidence that has been presented to support Rielle’s and Diethelm’s accusations in the press conference. 

Madame le Presidente,

During this trial, we have listened to numerous argument presented by Rielle and Diethelm and some conclusions by the Court, that are far away from the scientific truth and contain important errors. I would like to take this opportunity to examine some of the most flagrant of these errors from a scientific point of view. 

I have worked a researcher more that 40 years in the field of the environment. The role of a researcher is to use the scientific tools to examine new elements, study their effects, try to add data so far unknown and always question the established truth.  

I have published more than 300 articles in scientific journals. I have studied different factors in the environment and their interactions. Among my publications about 30 relate to the characteristics and effects of tobacco smoke. During my time at Geneva University from 1974 to 2000, I have published together with my collaborators some 30 publications, with the financial support from Philip Morris, on several environmental factors and their impact on human health. For my scientific work in general, I have been supported by international a well as national agencies. Regarding the support from Philip Morris, it accounted for about 5% of all the funding that I disposed for my research. 

In the press release by Rielle and Ditehelm

 

They accused me of a scientific fraud never ever seen 

This accusation is false! 

I interpreted this accusation as directed towards my work on tobacco smoke, Neither Rielle nor Diethelm have the competence to judge the scientific quality of my work on organic dusts, endotoxins, noise or metals. I have performed an analysis of all my publications on tobacco smoke and on environmental tobacco smoke. In a list of citations from these publications, one does not find any sentence, neither in the results nor in the conclusions, which would deduce one to think that I have denied the danger of tobacco smoke or ETS. 

In the judgement of 13 January 2003 

I was accused of betraying the public concerning the health of children and ETS 

This conclusion is false! 

We have in Geneva made three studies on the relation between environmental agents and health in children. The first comprised 90 children. In a preliminary analysis we found that there was a relation between respiratory symptoms and the smoking habits of the parents (=exposure to ETS). These results were presented at a Swiss scientific meeting, underlying that the results were preliminary. As we were interested in other factors in the environment, we continued the analysis of the material. There are reasons to believe that factors such as moulds in the home and the number of sisters and brothers could also be correlated to respiratory disease. If there is a relation between these factors and ETS, one cannot draw any scientifically valid conclusions regarding the risk caused by ETS.  It is thus necessary to perform a statistically evaluation that is rather complicated, otherwise one cannot reach any conclusions regarding the risk related to ETS. When performing this evaluation, we found that certain nutritional factors were more important than ETS. These are the results we reported at the following symposium. This does not mean that ETS is not dangerous; it only means that our group of children was exposed to agents which were more important than ETS. 

The second study was larger – it contained 304 children. During one of the hearings doctor Varonier declared with reference to this study that one must never make corrections in a database. We are completely in agreement with Varonier that one must never alter a database. In any case that would be very difficult without detection. There are several persons engaged in studies of this kind and after the collection of data till the publication of the results, the different analysis are registered and verified at different levels. The operation we performed was an evaluation of other factors using statistical methods as I previously explained. 

In his testimony Varonier criticized as for not having cited a Swiss study in which he himself participated. This study was published at the same time when our study was submitted for publication. Naturally one cannot cite something that is not known. When later examining the article Varonier referred to, I found that the authors reported that there was no relationship between ETS exposure and bronchitis. These are the same results as in our study – why did Varonier not mention that during his testimony? The reproduction of results in several studies is after all a support for the scientific validity of the data found n both studies. 

Our third study on children is not yet published but we have once again not been able to find a relationship between ETS exposure and infections among children. Why? This does not mean that ETS is without an effect – this has been shown in many studies and verified in a review by WHO. The reason is probably that people in Geneva where we did the study have heard that ETS is dangerous and avoid smoking in presence of their children. Maier et al who had also made a study where no effect was found between ETS exposure and health effects among children presented such a conclusion in 1997. In our third study we asked questions regarding the duration and the doses of ETS the children were exposed to. A majority of the parents answered that they never or very rarely smoked in presence of their children. Varonier has thus critized results that confirm the success of the information campaigns by Rielle and Diethelm, This is the old expression "shooting oneself in one’s own foot ". 

Another of our articles discussed during the hearings deals with the dietary habits among females living with smokers or non-smokers.  

Here I am accused of not citing the correct references and having hidden the origin of my financial support and my ties with Philip Morris 

These accusations are false! 

At the time we started the study, the difference in dietary habits between smokers and non-smokers was well known for instance in studies by the Geneva epidemiologist Morabia some ten years before our study. The conclusion in our article was "Dietary factors may thus be confounders in studies on the effects of environmental tobacco smoke and should be controlled for". Nothing on the risk and nothing trying to minimize the risk from ETS. 

In his witness professor Abelin accused us for not having cited three articles that showed that there was no influence of nutrition on the risk for cancer related to ETS. I am completely in agreement with Abelin that one must also cite articles that do not support one’s idea. At my request Abelin sent the reference to the three articles. I found, however, that he had not read them very carefully. In reality one does not find the evidence he claimed therein, a fact that I explained in a detailed letter to him. This witness is not acceptable from a scientific point of view. 

In any case the development during the time has supported us – today it is generally accepted that nutrition plays an important role in the development of cancer and that it may also influence lung cancer among smokers. In a recent study the international agency for cancer research in Lyon (IARC) concluded, "the combination of these two factors [ETS and dietary deficiency] can increase the risk for lung cancer among non-smokers up to two-fold". 

Regarding the transparency, we supplied the correct and complete information when we submitted the article for publication. The study was supported by the Centre for Indoor Air Research. This foundation was well known for being supported by the tobacco industry – information that was found in their advertising and in their forms for application for grants. In the declaration that we filled in for the European Journal of Public Health, that dr McKee showed during the trial, I confirmed that I did not have a conflict of interest. Contrary to what McKee said in his testimony, I have never denied my scientific relation with Philip Morris. My explanation on this was sent to McKee already in 2000 and published in his journal in 2001. This he never mentioned during his testimony.  

I have been accused of organising falsified symposia on ETS. 

This accusation is false!

 The symposia in 1974 and 1983 concerned an evaluation of the scientific knowledge at the time regarding the known effects of ETS. It was me who took the initiative to organise them and I did this together with a committee of researchers. The participants were chosen among those active in the field and with scientific competence. The conclusions and recommendations were circulated among the sponsors for comments and later sent to the participants for confirmation and agreement. This procedure is scientifically correct. During the years there was never any scientific criticism, neither on the conclusions nor on the participants. It is important that in both documents we strongly recommended further research and we made recommendations to improve the scientific quality of future studies. 

One has forgotten during the trial to mention that there was a third symposium in 1989 at which I made a review on cancer and exposure to ETS. I cite " the need to define precisely the exposure to the most important agent related to lung cancer namely tobacco smoke". Can that be interpreted as false information to minimise the danger of tobacco smoke?  

And finally some remarks concerning my relations with Philip Morris. 

I have been accused of being secretly employed by Philip Morris.

 This accusation is false! 

I have never hidden my relations with the tobacco or any other industry. These were known in the scientific world from participating in workgroups with representatives from the government and the industry to participation in scientific meetings together and joint publications.  

I have several publications with tobacco industry representatives. It is clear that when you publish in scientific journals that are read by thousands of persons, one cannot talk about a secret activity. Papers regarding the origin of my funds with Philip Morris letterhead were sent to our administration at Geneva University, which means that my relationship with the industry was known by the university administration as well as by the institute of social and preventive medicine. Regarding INBIFO that was also no secret. This institute is the best inhalation research institute in the world and has published more that 100 articles on the effects of tobacco smoke and ETS in scientific journals – once again not a means to remains secret. 

I am accused of being secretly employed by Philip Morris

 This accusation is false!

 The means of collaborating with industry is very important for s researcher. In my connections with the industry, tobacco or other, I have always asked for and obtained a total scientific freedom. It was every time me who took the initiative for research projects. It was me who had the idea to organise symposia and conferences. I was me who prepared the scientific reports and was responsible for their content. I have never accepted the role to be the industry representative in contacts with other researchers such as dr Thorn. 

I was never employed by Philip Morris. My principal role was a scientific consultant at INBIFO and I supervised the research programme on technical and administrative matters, as verified by Philip Morris in a recent correspondence. The document that Rielle and Diethelm have shown the Court is a contract on confidentiality regarding products and commercial secrets and nothing else. 

Regarding my payment the Court cited $ 85'000 as a sum for personal remuneration. In fact this sum was also to cover costs for transportation to Cologne and Geneva. The sum I retained for personal use was in the order of $15’000-20’000 per year that corresponds to an hourly rate of about 300 Swiss francs. This does not allow one to draw the conclusion that I was the most highly paid consultant.

Conclusions

 In conclusion this trial has not been able to show neither in my publications nor in my actions any sign or evidence of falsification or disinformation. I know that my case is not very popular as many persons think including the media think that collaboration with the tobacco industry is collaborating with the Devil. What I have tried to show you is that such collaboration under strict scientific rules can produce results that are valuable for the identification of the risk related to smoking. For me the collaboration with the researchers at INBIFO has been a thoroughly positive experience and I am proud of this collaboration where we have explored problems of relevance for health. 

During our research in Geneva and Gothenburg we have launched new ideas regarding the importance of different factors in the environment for health. These ideas might have been controversial at the time of their discovery and could be displeasing for persons attached to traditional dogma or who have a limited scientific understanding of scientific principles. Our results show however the complexity of the relation between the environment for example ETS and the effects on health. This complexity is not unexpected and demonstrates the necessity to continue research in this area to obtain an optimal public health policy.