Identifying the environmental causes of disease

In 2006 the Academy of Medical Sciences established a working group on research into the environmental causes of disease. Its objective was to address increasing scepticism amongst professionals and members of the public that had arisen when claims from one study were so soon contradicted by those of another.

For instance, until recently hormone replacement therapy was thought to protect against cardiovascular disease, but it is now thought to be a risk factor. Nevertheless, in some cases, such as the link between smoking and lung cancer, research on the environmental causes of disease has clearly been of great value to public health.

The final report of the working group sets out five key recommendations and offers guidelines for the wide range of stakeholders involved in generating, communicating and translating research into the environmental causes of disease into policy and practice. A synopsis, summary of the stakeholder workshop that informed the working group's discussions and press release accompany the report.

Professor Sir Michael Rutter CBE FRS FBA FMedSci (chair)
Vice-President, Academy of Medical Sciences

Professor Philip Dawid
Professor of Statistics, University of Cambridge

Dr Aroon Hingorani
Reader and Honorary Consultant and British Heart Foundation Senior Fellow, University College London

Dr Richard Horton FMedSci FRCP
Editor, The Lancet

Professor Peter Jones FMedSci
Professor of Psychiatry, University of Cambridge

Professor Kay-Tee Khaw CBE FMedSci
Professor of Clinical Gerontology, University of Cambridge

Dr Bill Kirkup
Director General for Programmes, Department of Health

Dr Geoff Mulgan
Director, Young Foundation

Professor Catherine Peckham CBE FMedSci
Professor of Paediatric Epidemiology, Institute for Child Health

Professor Andrew Pickles
Professor of Epidemiological and Social Statistics, University of Manchester

Professor Robert Souhami CBE FMedSci
Emeritus Professor of Medicine, University College London

Dr Geoff Watts FMedSci
Freelance Science and Medical Journalist

Professor John Savill FRSE FMedSci (chair)
Vice-Principal and Head of the College of Medicine and Veterinary Medicine, University of Edinburgh

Professor Yvonne Carter OBE FMedSci
Dean and Pro-Vice Chancellor (Regional Engagement), Warwick Medical School and the University of Warwick

Professor Rudolf Klein FMedSci
Visiting Professor, London School of Economics

Professor Sally MacIntyre CBE FRSE FMedSci
Director of the Social and Public Health Sciences Unit, Medical Research Council

Professor James Robins
Mitchell L and Robin LaFoley Dong Professor of Epidemiology, Harvard University

The terms of reference were to:

• To investigate the strengths, limitations and potential of non-experimental methods.
• To investigate the lessons that might be learnt from successful and less successful examples of non-experimental research.
• To investigate how non-experimental studies should deal with complex multi-factorial causes.
• To investigate how experimental and non-experimental approaches should be coordinated to identify causal mechanisms of disease.
• To investigate how non-experimental research is communicated, the value placed by individuals, society and government upon such research and how the results impact on policy and the decision-making of individuals.

The working group did not:

• draw conclusions in relation to any particular disease outcome or set of risk factors other than as examples to help illustrate broader principles; or
• consider issues related to legal liability.