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Until recently, I was angry that the medical debate about limit values was conducted exclusively by epidemiologists, toxicologists or environmental health professionals. Where was the voice of German lung medicine on the subject? Last Wednesday I wished she had never risen.
Nearly 100 German pulmonary physicians have signed a statement denying the scientific basis of the currently applicable limit values for particulate matter and NOx. This is not problematic in itself. Criticism of the limits and above all of the proportionality of the proposed driving bans is quite appropriate.
I am convinced that most of my colleagues have volunteered their support in good faith. Unfortunately, the thing is not so easy here. Because the statement triggered a media hurricane, exposed the communicative incompetence of science and led to a collision with the "post-fatal" era. How could this happen?
The colleagues followed with their signature of the statement the call of the former president of the German society for pneumology, Professor Dieter Köhler, initiator of the writing and for a long time in the role of the "Renegaten" present: a lung physician, the health dangers by NOx or fine dust for simply "invented" holds - found food for the media world.
Among the signatories of the statement are many well-known colleagues of mine, good, conscientious physicians. Did they realize at the time of signing that they would overnight become stirrup-holders of a "lie all" ("image") campaign? In the name of these colleagues, hundreds of qualified scientists, some of whom have been dealing with the subject for decades and whose papers have been published in peer-reviewed medical journals, are not accused of over- or misinterpreting data, but simply of deliberate lies.
A disservice to science
Maybe that was not foreseeable for most signers, it was always naive. Because they should have known that they support with their signature individual persons, the scientific knowledge for a "joke" ("hard but fair"), other researchers dissenting opinion for "ideologized" or members of a "sect" ("Cicero "), and like to compare the whole border debate with the witch hunt. The sentences say like "there is no fine dust disease of the lungs" (ARD "The Diesel Disaster") and in a circular claim that lung doctors saw daily deaths in everyday life COPD and lung cancer, "but dead by fine dust and NOx no". In short: Nitrogen oxides and particulate matter are not responsible in Germany for a single death.
All of these "robust" views and statements were co-signed by my colleagues on Wednesday - and thus the scientific debate did a disservice. Because good - scientific - arguments are sought in the opinion in vain. Only allegations are made without citing even a single study underpinning these theses. For example, it is claimed that smokers' "voluntary exposure study falsifies the studies on the relationship between low-particulate matter and NOx with reduced life expectancy: Because cigarette levels are many times higher than those in outdoor air, smokers would have to die much earlier than they actually do.
With this handy comparison Köhler pulls for months through the German TV landscape. Ironically, one could argue exactly the opposite: this pure assumption (hypothesis) is often falsified by the numerous cohort studies (experiments) on the subject.
Another proof of the "trumpeting" of society
The position paper published in November 2018 by the German Society for Pneumology, which presents the state of science and essentially supports the current limit values, shows how serious a scientific examination of the subject looks like. It has a volume of over 50 pages and 451 references. Although mass is not a class, it would have been desirable for the opinion to refute one or the other study that refutes the current state of research (that NOx or particulate matter is very harmful in concentrations measured in Germany).
The media reaction to the statement was foreseeable. Out of almost one hundred - mostly in private practice - signing colleagues were "renowned scientists" ("The World"), Transport Minister Scheuer welcomed the "scientific approach". 50 pages position paper, 451 quotes and countless studies on the topic: wiped off 2 pages of an opinion without a single document or at least concrete proposal on how to improve the "missing scientific basis" of the limits.
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How far the "trumpisation" of our society and individual media has already progressed was evident in the public discussion: reproducible evidence that does not fit is used with the "Fake News" vocabulary of "lie", "invention", "hysteria" and "ideology" defamed. What you can not refute, you just do not believe. The picture that will remain of medical science after this controversy is a badly damaged one.
The stereotype of the academic jumble who does not know what he is talking about is excellently served. This pleases all those who believe that the pursuit of objective knowledge is in any case dispensable ballast. Even the professional societies do not give a good picture in this debate. After the judgment of Leipzig passed several months unused to make the voice of the lung medicine audible. The societies as spokespeople should have conveyed the state of knowledge, but at the same time had to name unanswered questions and appropriately correct distortions such as those of the "13,000 diesel deaths" (DUH).
When the position paper appeared in December, the debate had long since gotten out of hand. To capture them again is likely to be a Herculean task. In my view, pulmonary medicine has missed a great opportunity to recall its paramount importance to the public. In fact, she drove the discussion against the wall.