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Comments from independent epidemiologists on the Pesticides Literature Review published by the Ontario College of Family Physicians

The Pesticides Literature Review published by the Ontario College of Family Physicians (OCFPA) was considered by the Advisory Committee on Pesticides (ACP) at their meeting in May 2004.

Following the May 2004 Advisory Committee on Pesticides (ACP) meeting, five epidemiologists were asked to give an independent assessment of the “Ontario review”.  Those consulted were the two epidemiologist members of the Committee on Carcinogenicity (who provided a joint report), two epidemiologists from the Committee on Toxicity, and the Chairman of the Advisory Group on Non-Ionising Radiation.  Each was provided with a web link to the paper on the OCFPA website, and advised that although there were no new data in the review, it had generated considerable interest amongst pressure groups.  Their individual comments were sent direct to the Secretariat.

Overall, the views submitted accorded with those expressed by the Chairman in his paper, ACP 12/1 (307/2004), that was discussed at the May ACP meeting.  All of the experts consulted felt that the review had major shortcomings, and several commented that the conclusions drawn were not justified by the analysis presented.  A summary of the main points of criticism is presented in Table 1.

TABLE 1

Criticisms of the 'Ontario Review'

	1	2	3	4	5
Only looked at post 1992	+			+	+
Exact search strategy and selection criteria not specified	+	+
Incomplete identification of studies during target period	+	+	-	+
Selective reporting of results	+		+	+	+
Inappropriate grouping of some diseases					+
Limitations from lumping all pesticides together			+
Inadequate understanding and consideration of relevant toxicology	+	+	+
Insufficient attention to routes and levels of exposure	+	+	+	+	+
Failure to consider impact of strengths and weaknesses of individual studies	+	+		+	+
Superficial synthesis of evidence	+	+		+	+
Conclusions unhelpful and not justified	+			+	+