Monday, May 23, 2005

Suppression Bias: Uncovering the Coverup of the Corporate Coverup

What is the matter with David Egilman anyway?

The Associate Professor at Brown University is under the curious impression that civilized countries should expect companies to commit corporate suicide by revealing the conclusions of studies that show that their products are harmful. More outrageously, Egilman thinks that scholarly scientific journals have some responsibility to uncover corporate cover-ups and corruption of science.

It all began in 2003, when Egilman submitted an article for publication in the Journal of Occupational and Environmental Medicine (JOEM)that stated that Dow Chemical was covering up evidence that asbestos in a Texas chemical plant had caused a high number of mesotheliomas. (Mesothelioma is a fatal lung cancer only caused by exposure to asbestos.) Egilman cited a Dow study that concluded that 11 cases of mesothelioma among its 28,000 employees did not suggest a work-related cause, even though the usual incidence of mesothelioma is around one or two cases per million. When a company chooses not to share that information with workers, customers, and the general public, especially when the studies reveal alarming health consequences, it's called "suppression bias."

The Journal, however, refused to publish Egilman's article, not because it found it of low quality, but because the subject was “not likely to be a high priority for the majority of JOEM readers.”

Finding it difficult to believe that occupational health specialists would not find evidence of corporate corruption of scientific research to be a "high priority," Egilman simply bought two pages of advertising space in the Journal and ran the entire rejected manuscript anyway.

JOEM editor, Paul Brandt-Rauf, was incensed. Claiming that he wouldn't have allowed the advertisement if he had known about it, he allowed Dow to publish a response, but then refused to allow Egilman to publish a rebuttal.

Now, two years later, Egilman's has published in this month’s International Journal of Occupational and Environmental Health not only rebuttle to Dow, but also a critique of IOEM's ethics. Dow's behavior was hardly surprising, according to Egilman; suppression bias is all too common. JOEM's behavior, on the other hand was deeply disturbing.
Milton Friedman pointed out many years ago that “the [only] social responsibility of business is to increase profit,” and many agreed. Corporations’ desire to maximize profitability means that adverse health information has often been hidden from workers, customers, and the scientific community. Industry influence over scientific production becomes much more alarming when it is condoned, and even aided, by a respected occupational and environmental health journal. Peer-reviewed journals are supposed to function as the unbiased medium through which researchers exchange and critique each others’ ideas, experiments, and conclusions. Conflict-of-interest policies, peer-review procedures, and funding-disclosure rules are meant to assure authors and readers that journals are indeed functioning as neutral arbiters of important scientific research and discussion. However, experience shows that even well-known journals at times pursue an agenda that seems more favorable to corporate interests than to scientific integrity.
Dow's assertion that the mesotheliomas were not work related barely passes the scientific version of the laugh-test considering that the plant "not only had thousands of feet of pipes covered in asbestos insulation, but also used thousands of tons of asbestos in the chlorine-production process." Furthermore, although the 11 mesothelioma cases themselves were far higher than expected, Dow failed to study possible cases of mesothelioma among the plants contract employees:
These workers, whom Dow refers to as “spares,” have some of the highest exposures of all plant workers, yet are intentionally excluded from studies of “Dow workers” because they are not technically employees of the company. In their response, [Dow's] Burns and Kociba defend this decision, stating it is typical practice. We agree. Worker cohorts in corporate studies rarely include subcontractors precisely because they often have higher exposures and hence higher rates of disease. But the fact that excluding these workers is common practice does not make it good practice.
According to an article in the London Times, Brandt-Rauf was not amused and the battle continues:
Professor Brandt-Rauf has come out with his fists raised. “I don’t know where he [Egilman] gets this idea that he gets to publish anything he wants in the journal of his choice,” Brandt-Rauf told The Scientist last week. “If that were true, I’d publish all of my pieces in Nature and Science.” If Egilman needed any more fuel for his fury, it came in Brandt-Rauf’s comment that, had he seen the ad before publication, he would have vetoed it.

That, Egilman writes, “is even more troublesome”, because it shows a willingness to censor advertising material that does not toe the editorial line. A commentary accompanying Egilman’s tart review points to associations between the JOEM and Dow, and says that Dow is a significant contributor to Columbia University, which employs Brandt-Rauf. It isn’t meaty conspiracy fodder, but it turns out that an organisation affiliated to JOEM once gave Dow a “corporate health achievement award”. Still, the acrimonious tussle provides an insight into the practice and dissemination of corporate science.
All of this would probably be upsetting to most Americans who don't realize that most chemical testing in this country is done by the companies that manufacture the chemicals. In his original article/advertisement Egilman pointed out that “Dow Chemical Company operates one of the largest private toxicology research units in the United States.” In an ideal world, this information will be peer-reviewed and the results provided to affected workers, other scientists and the regulatory authorities who could then use the information to decide whether or not exposure to the substance needs to be controlled or eliminated. Even without regulation, workers and consumers could use the information to take some kind of action.

For example, publication of health effect information discovered in 1993 by BASF about a chemical called diacetyl might have been useful for the thirty employees of a Missouri popcorn plant who now need lung transplants because no one informed them that the chemical was known to destroy the lungs of rats.

But that's not the society we live in. Snakes gotta bite, bees gotta sting, and companies seem to think they gotta cover up damning health information about their products.

The priorities of a journal such as JOEM are a different matter. The journal is the organ of the American College of Occupational and Environmental Medicine, a group dedicated to “promoting the health of workers through preventive medicine, clinical care, research and education.” Such a journal should eschew corporate interests, and actively work to uncover science hidden by interests that do not prioritize the pursuit of truth. Instead, the journal has chosen to contribute to the obfuscation of information harmful to Dow, but vital to many workers’ health. JOEM must re-examine its priorities if it is to secure a place as an important publication in the field of occupational and environmental health.

When this affair first broke in 2003, I wrote that, although workers were accustomed to being screwed by companies who cover up health information, they were in big trouble if the JOEM is right and occupational health professionals truly are not interested in fighting the corruption of science. Publication of Egilman's work by the International Journal of Occupational and Environmental Health puts some of those fears to rest.

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