The magazine for alumni and friends of Massey University.
Issue 14, April 2002

The Research School of Public Health

Professor Neil Pearce and the Centre for Public Health Research

The practice of clinical medicine has a certain glamour, but it wasn’t treatment or immunisation that brought such 19th century killers as tuberculosis and cholera to bay, but widespread advances in housing sanitation and nutrition – in other words, public health. And today it remains such things as housing, nutrition, and the hazards associated with work that by and large determine the health of New Zealanders.
Massey’s new Research School of Public Health creates a cluster of public health expertise. The school is made up of the Auckland-based SHORE Centre; Te Pümanawa Hauora, the Wellington-based Centre for Public Health Research; and the Sleep/Wake Research Centre.
The Centres will share information between their disciplines, and draw on the expertise within the wider University.
The School is expected to play a significant role in public policy.

Near the end of the 1970s Neil Pearce, now the director of Massey’s fledgeling Centre for Public Health Research, earned a living driving Wellington’s big reds.
He had been studying seemingly forever at Victoria and Otago in his chosen disciplines of mathematics and statistics, and driving a bus around Wellington for a living had been an attractive option. He gave up after about a year – “because I worried I might run over someone and kill them”, he grins. But after more than two decades to the international fore of research into asthma and other key public health issues, Pearce looks back on his old job as the start of it all.

He believes the stint ‘on the buses’ was crucial in shaping his awareness of public health issues, significantly from the perspective of the workers.“ I saw first hand what people’s occupational problems were, from shift work, stress, exposure to chemicals and the like. It got me interested.” When he next applied for a job – as an orderly at Wellington Hospital – he was turned down. But the hospital had the good sense to recognise his qualifications, referring him to its adjacent medical school, which took him on as a biostatistician.

Including stints researching occupational cancer at the University of North Carolina and at the International Agency for Research on Cancer at Lyon, France, there followed a prolific and ground-breaking research career.

His work was key in proving the importance of socio-economic factors to life expectancy in New Zealand – innovative thinking in the 1980s – and subsequent work in the Bay of Plenty spurred a national catch-up Hepatitis B immunisation campaign for children.

Other work looking at the high incidence of certain cancers in agricultural workers was instrumental in showing that pesticide usage was less significant causally than had been thought.

An observation that freezing workers had a particularly high cancer rate engendered the belief that a virus or other biological exposure from animals could be responsible – though no one has been able to pin it down precisely.

It was in the 1990s, however, that Pearce started what was to become his best-known and most influential research.

At the time New Zealand had the highest asthma-related mortality rate in the world. “ We discovered it was due to a drug called fenoterol,” he says. The discovery led directly to the drug’s restriction in New Zealand, Australia and Japan, and its dosage being halved in other countries by its manufacturers. As a result mortality rates plummeted, and have remained at a third of the level they were before.

Latterly, in the ambitious International Study of Asthma and Allergies in Childhood (ISAAC), developed by groups in Auckland, Wellington, London and Germany, Pearce has helped dispel the myth that New Zealand has the worst asthma prevalence in the world.

The study’s first phase, sampling 750,000 children from 160 centres in about 60 countries, produced a clear finding that asthma rates were just as high in other English-speaking countries.

“ We wasted about 15 years saying New Zealand is unique,” Pearce says. “There has been an incredible amount of speculation about factors like house dust mites, cats, pollens and other things that might be special about New Zealand. Instead we should be asking what New Zealand has in common with other countries like Australia, Britain, Ireland, Canada and the United States, all of which have just as much asthma as we do.

“ There are places like Tucson (Arizona) where there are no dust mites because it is so dry. But it has exactly the same prevalence as us.” All very well. But if dust mites aren’t the cause, are we any closer to knowing why people contract asthma in the first place?

“ There’s a new theory known as the hygiene hypothesis. If you get – as in the old days – lots of infections early in life, this protects you against getting asthma later on. “ Maybe now we’re too clean and we’ve lost that protection. If we could work out how this happens, then maybe we could work out how to prevent asthma.”

When work makes people ill
As well as asthma, the Centre is conducting work on Mäori and Pacific health, cultural safety and occupational health.

The overwhelming interest from the Labour Department’s Occupational Safety and Health (OSH) and the Accident Compensation Commission has rested with workplace accidents, says Professor Pearce, but occupational cancer causes about five times as many deaths as occupational accidents.

The research team is involved in a big study of workplace cancer in conjunction with OSH.
“ There’s not just cancer,” he says. “There’s also respiratory disease, hearing loss, neurological effects of solvents…”