Although this is APHA's most prestigious award, it generally isn't very newsworthy. But this year seems to be an exception, at least for the Wall St. Journal, which devoted a 1200 word editorial swiftboating Dr. Levy for allegedly "compromising his professional ethics" and holding him up as the symbol of all that is wrong with the American legal system that allows victims of asbestos and silica disease to sue manufacturers for the deadly diseases caused by these minerals.
I'll go into the details of this case in a minute, but first everyone who cares about finding the truth in public health needs to understand that the attack on Dr. Levy is just the latest chapter in the long and dishonorable tradition of attacking the ethics of those who tell the truth rather than attacking the issues. Dr. Levy is just the latest target in the increasingly vicious battle between politics and science, between corporate profits and public health.
We've seen these same attacks too many times before, most recently by the chemical industry against the "unethical conduct" of historians Gerald Markowitz and David Rosner for their book Deceit and Denial: The Deadly Politics of Industrial Pollution which extensively documents how the chemical industry spent years covering up and lying about the hazards of vinyl chloride, a widely used chemical known to cause cancer.
Other recent attacks on occupational health worker advocates include IBM's 2004 attempt to suppress the publication of a paper by Drs Joe LaDou and Richard Clapp showing that large numbers of IBM workers have died prematurely of cancers and other diseases due to their exposures to toxic chemicals at IBM facilities.
Prior to this (and still ongoing) was the lead industry's attack on the ethics of Dr. Herbert Needleman for his shocking conclusion that children's exposure to low levels of lead harmed their intelligence and behavior. And before that, the asbestos industry viciously attacked Dr. Irving Selikoff for his pioneering work on asbestos-related cancer.
And on and on and on.
Well, as they say, you're known by the enemies you make....And Dr. Levy has antagonized some of the best, so he must be doing something right.
The details of the case are somewhat more mundane the fireworks ignited by the Journal. The case revolves around the paper's accusation that Dr. Levy essentially lied about his review of thousands of workers' medical records in his role as a scientific expert in court cases to determine whether workers showed signs of silicosis.
According to the National Institute for Occupational Safety and Health (NIOSH)
Silicosis, an irreversible but preventable disease, is the illness most closely associated with occupational exposure to the material, which also is known as silica dust. Occupational exposures to respirable crystalline silica are associated with the development of silicosis, lung cancer, pulmonary tuberculosis, and airways diseases. These exposures may also be related to the development of autoimmune disorders, chronic renal disease, and other adverse health effects.
The medical "experts" at the Journal extensively cite a judge who criticized Dr. Levy for stating his expert opinion, based on their records, without personally examining the patients, not understanding (or not wanting to understand) that it is standard practice in such legal cases for experts to do a careful records review in order to determine whether the cases meet the medical criteria for silicosis.
The Journal then goes from silly to ridiculous quoting the judge's criticism of Dr. Levy for allegedly ignoring his own published advice when he "tells doctors that if they diagnose even a single work-related illness, they should inform employers or a government agency, to prevent others from getting sick."
What neither the judge nor the Journal apparently understood was that not only was Dr. Levy not the treating physician, but the whole point of encouraging doctors to inform employers or government agencies is to ensure that occupational diseases are not overlooked -- which was hardly the problem here.
This story also seems to be an good example of problems with the 1993 Daubert Ruling. As I wrote in 2003 about a review of the significance of Daubert:
Daubert was originally intended to assist judges in determining what evidence could be admitted into a trial. But as the authors explain:There is far more to this case and far more to the attacks on the defenders of worker and public health than I have time for here. In fact, the entire purpose of this excercise in pit bull public health is revealed in one sentence of the Journal's editorial: The paper argues that Dr. Levy's diagnoses are "amazing, given that silicosis has become rare in the U.S."The 1993 Daubert ruling directed federal judges to act as "gatekeepers" in the courtroom, using a standard that requires expert testimony to be both reliable and relevant before allowing it to be presented to juries. However, over the past 10 years, some judges have misinterpreted and broadened the reach of Daubert. Some have excluded scientific opinions when there is (or appears to be) disagreement among legitimate scientists; while others pick apart each piece of the scientific evidence presented by an expert rather than assessing the evidence as a whole, the way scientists do.What this means is that when corporate attorneys manage to cloud the science and confuse the judges, the evidence gets labeled as “junk science” and good cases often get dismissed by the judge before they even get to a jury. Victims of toxic chemicals and drugs are the losers.
Rare? Hardly. In fact, NIOSH reports that
At least 1.7 million U.S. workers are exposed to respirable crystalline silica in a variety of industries and occupations, including construction, sandblasting, and mining.Ironically, even George Bush's OSHA wouldn't agree with the Journal on this point. OSHA claims that each year more than 250 workers die from silicosis and a stronger silica standard is one of the few regulations on which OSHA claims it is actively working.
In fact, amazing as it may sound, I think that by attempting to discredit Dr. Levy, the Wall St. Journal may be trying to make the silicosis problem -- and its victims -- disappear.
It would hardly be the first time.