Where is NIEHS headed?

Since he took the post in April of 2005, David A. Schwartz's management of the National Institute of Environmental Health Sciences has been under siege. Changing scientific priorities, allowing the support of the institute's esteemed research journal to erode, and neglecting the National Toxicology Program (NTP)—an interagency program that assesses chemicals for health effects—are among the major complaints during his short tenure. The situation got so bad that Schwartz was forced to temporarily step down as director of NIEHS in August as investigations into his actions were started by the National Institutes of Health and by Congress. NIEHS is located in Research Triangle Park, N.C.

As a part of its probe, the House Subcommittee on Domestic Policy, headed by Rep. Dennis J. Kucinich (D-Ohio), held a hearing on Sept. 25 on the recent developments at NIEHS. It became apparent from the testimony that Schwartz had initiated many changes at the agency that the new acting director, Samuel H. Wilson, has repudiated. It also became clear that the reforms Schwartz made represented a sharp departure from the agency's policies of the past. The hearing focused on the scientific and clinical changes Schwartz has made and did not discuss issues of financial mismanagement that have also been raised. Schwartz was not asked to testify at the hearing.

Soon after becoming director of NIEHS and NTP, Schwartz set in motion a new set of research priorities for the institute, Kucinich said as he opened the hearing. Schwartz shifted "significant resources toward research that was clinical in nature and was focused on discoveries that would contribute to treating or curing disease once the patient was already afflicted," Kucinich said. In addition, he noted, Schwartz shifted resources away from projects or programs that did not fit the definition of basic research. Inherently, Kucinich explained, the clinical research Schwartz proposed was sound, but there are not enough resources to do the new research and still maintain NIEHS's traditional focus on disease prevention.

Schwartz, formerly a pulmonologist at Duke University Medical Center, also neglected to fill leadership positions at the institute's prestigious research journal Environmental Health Perspectives (EHP) and at NTP, Kucinich said. Instead, Schwartz started several new initiatives, mostly clinical in nature, that cost more than the combined salaries for the vacant positions, Kucinich explained. "What are we losing by shifting resources toward new endeavors?" he asked.

George W. Lucier, who served 28 years as editor of EHP, testified that during his tenure, the journal grew from a fledgling publication that announced workshops and released conference proceedings to a leading research journal. When Schwartz became NIEHS director in 2005, EHP was recognized as the world's foremost environmental health journal, Lucier said. Its impact had increased steadily while its costs steadily declined, he said.

"But in a puzzling series of moves, Schwartz began dismantling the journal," Lucier said. The staff at EHP had included an editor-in-chief, two science editors, and a news editor, he explained. Now, he said, the journal has an interim editor and no science editor, and the news editor has been temporarily reassigned to work in the NIEHS director's office. Previously, EHP offered Chinese and Spanish editions; these are no longer available. Ending the Chinese and Spanish editions undercut NIEHS's goal of "sharing environmental health information with countries that need it and want it," he said. EHP's student edition has also been discontinued.

Schwartz's actions toward EHP were inconsistent with the mission of the agency—to understand and prevent environmentally mediated diseases—and undermined "strategies for effective communication of critical environmental health information to those who need it most," Lucier said. He urged that the EHP staffing levels be restored and that the budget be increased to the 2005 level in constant dollars.

Lucier also criticized Schwartz's actions as director of NTP, which is housed at NIEHS. Schwartz appeared to "view NTP as an inconvenient annoyance rather than an integral part of his job," Lucier said. In contrast, the previous NIEHS/NTP directors, David P. Rall, now deceased, and Kenneth Olden, "were ardent champions of the NTP mission," Lucier observed.

Under Schwartz's leadership, the number of new chemicals studied by NTP dropped dramatically from 10 in 2005 to four in 2007, Lucier said. Furthermore, Schwartz did not fill vacant positions at NTP with permanent employees. In 2005, Schwartz removed Christopher Portier as associate director of NTP and appointed an interim director. The position was not staffed with a permanent associate director until this August. Lucier also said he could not understand why NIEHS is building a clinical center on its campus. The campus is adjacent to world-class hospitals at the University of North Carolina and Duke University, both of which have excellent clinical centers, he explained.

Along with the litany of criticisms, Lucier did point out that Schwartz initiated several valuable projects at NTP, including toxicology studies of nanoscale materials, herbal medicines, and drinking water.

At the hearing, Lynn R. Goldman, professor of environmental health sciences at Johns Hopkins University's Bloomberg School of Public Health, observed that, for the U.S. population, the total cost of environmentally related diseases is about $520 billion to $740 billion per year, and for children alone, the annual cost is around $55 billion. She noted that NTP has an important function in reducing this burden of disease. The methods it developed for assessing the carcinogenicity of chemicals are the "gold standard" worldwide, she said. Its report on carcinogens published in 2005 includes assessments of 246 agents of which 58 are known human carcinogens, while the remaining 188 are "reasonably anticipated to be human carcinogens."

These evaluations can play consequential roles in government decisions, Goldman testified. For example, on Sept. 4, the Federal Emergency Management Agency announced that it would allow 60,000 families displaced by Hurricane Katrina and living in trailers on the Gulf Coast to move into motel rooms if they are concerned about exposure to the probable carcinogen formaldehyde in the trailers. Formaldehyde concentrations 75 times the Environmental Protection Agency safe level have been measured in some of the trailers, she said. FEMA has received more than 2,875 requests for alternative housing.

NIEHS also has played an important role in establishing Centers of Excellence in Children's Environmental Health Research, centers that examine how race, economics, and behavior affect children's health, and in helping to establish the National Children's Study, Goldman said. That study is an ambitious nationwide project that will follow 100,000 children from before birth to the age 21, with the goal of characterizing the effects of environmental factors on health and development. But the agency's support for the centers and for the study has ended, she said. "It is difficult to understand why NIEHS has not been supportive in recent years," she observed.

Some of Goldman's points were reinforced by Peggy M. Shepard, executive director of We Act, an environmental justice organization. She testified that "NIEHS has recommended a cut in funding and a radical change in the funding mechanism for the children's health centers." The centers provide robust data on exposures and health outcomes for thousands of individuals from birth through childhood, she said. The agency proposed to change the centers from entities that support multidisciplinary research into facilities that provide only research infrastructure, she said. "NIEHS proposes a retreat to the laboratory," she noted.

Stephani D. Hines, a member of the National Advisory Environmental Health Sciences Council, which advises NIEHS, expressed concerns about the erosion of disease-prevention educational activities in the NIEHS portfolio. Even though the agency's strategic plan makes provision for such activities, she said, "the reality is that outreach and education programs are being significantly reduced." The reduction in outreach programs has violated trust within the outreach and educational communities, she added.

In his sworn testimony, NIEHS Acting Director Wilson promised to support the children's disease prevention centers, as well as the community-based research program. "I fully support these programs because they are incredibly effective," he said. But NIEHS's Environmental Justice Program is still undergoing review and may not be funded, he said. Even if the program is eliminated, NIEHS will support environmental justice research.

Wilson also said that EHP would be restored as a vehicle for communicating cutting-edge health research to a broad public and that NIEHS would abandon efforts to privatize the journal. "We are committed to restoring any cuts to the journal, including the Chinese edition," he said. "I can assure you that the interests of EHP will be fully represented and supported in the [fiscal] 2008 budget." He also promised to fill the position of EHP editor-in-chief on a permanent basis. (Despite his promises, EHP is still operating with five interim editors and about half its previous staff.)

Regarding the strategic direction of NIEHS, Wilson stressed at the hearing his commitment to disease prevention. "I want to state categorically that prevention of illness is a priority of mine and, indeed, all of NIH," he said. "The mission of NIEHS is to support research to define the role of environmental agents in the initiation and progression of human disease."

At the close of the hearing, it was apparent that most of the changes at NIEHS Schwartz attempted during his tenure will not be continued. Some of the witnesses said they do not expect him to return to the agency, but in messages to the NIEHS staff, Schwartz says that he will return. Schwartz provided no comment on the hearing to C&EN.