Industry groups are
fighting government regulation by formenting scientific
uncertainty
Few scientific
challenges are more complex than understanding the health risks
of a chemical or drug. Investigators cannot feed toxic compounds
to people to see what doses cause cancer. Instead laboratory
researchers rely on animal tests, and epidemiologists examine
the human exposures that have already happened in the field.
Both types of studies have many uncertainties, and scientists
must extrapolate from the evidence to make causal inferences and
recommend protective measures. Because absolute certainty is
rarely an option, regulatory programs would not be effective if
such proof were required. Government officials have to use the
best available evidence to set limits for harmful chemicals and
determine the safety of pharmaceuticals.
Uncertainty is
an inherent problem of science, but manufactured uncertainty is
another matter entirely. Over the past three decades, industry
groups have frequently become involved in the investigative
process when their interests are threatened. If, for example,
studies show that a company is exposing its workers to dangerous
levels of a certain chemical, the business typically responds by
hiring its'. own researchers to cast doubt on the studies. Or if
a pharmaceutical firm faces questions about the safety of one of
its drugs, its executives trumpet company sponsored trials that
show no significant health risks while ignoring or hiding other
studies that are much less reassuring. The vilification of
threatening research as "junk science" and the corresponding
sanctification of industry-commissioned research as "sound
science" has become nothing less than standard operating
procedure in some parts of corporate America.
in 1969 an
executive at Brown & Williamson, a cigarette maker now owned by
R. J. Reynolds Tobacco Company, unwisely committed to paper the
perfect slogan for his industry's disinformation campaign:
"Doubt is our product since it is the best means of competing
with the 'body of fact' that exists in the mind of the general
public." In recent years, many other industries have eagerly
adopted this strategy. Corporations have mounted campaigns to
question studies documenting the adverse health effects of
exposure to beryllium, lead, mercury, vinyl chloride, chromium,
benzene, benzidine, nickel, and a long list of other toxic
chemicals and medications. What is more, Congress and the
administration of President George W. Bush have encouraged such
tactics by making it easier for private groups to challenge
government-funded research. Although in some cases, companies
may be raising legitimate arguments, the overall result is
disturbing: many corporations have successfully avoided expense
and inconvenience by blocking and stalling much needed
protections for public health.
A GOOD EXAMPLE of the current battles
between industry and science is the controversy over beryllium.
This lightweight metal is vital to the production of nuclear
warheads because it increases the yield of the explosions;
throughout the cold war, the U.S. nuclear weapons complex was
the nation's largest consumer of the substance. Beryllium and
its alloys are now used to make electronics equipment and even
golf clubs. But the metal is also extremely toxic--breathing in
tiny amounts can cause chronic beryllium disease (CBD), a
debilitating ailment that scars the lungs. Victims have included
not just the machinists who worked directly with the metal but
others simply in the vicinity of the milling and grinding
processes, often for very short periods. One accountant
developed CBD after working for a few weeks each year in an
office near where beryllium was being processed. CBD has also
been diagnosed in people living near beryllium factories.
As assistant secretary of energy for
environment, safety and health from 1998 to 2001, I was the
chief safety officer for the nuclear weapons complex,
responsible for protecting the health of workers at production
and research facilities as well as for safeguarding the
surrounding communities and environment. When President Bill
Clinton appointed me, the Department of Energy's exposure
standard for beryllium had not changed since 1949, some years
after the substance's health dangers had become clear. In
response to a crisis involving many sick workers and community
residents, two scientists working with the Atomic Energy
Commission estimated what they thought to be a safe level--two
micrograms of beryllium per cubic meter of air--while they were
riding in a taxicab on their way to a meeting. The commission,
the predecessor of the DOE, then implemented the so-called
taxicab standard.
When the Occupational Safety and Health
Administration (OSHA) was established in 1971 to protect the
health of workers in the private sector, it, too, adopted the
taxicab standard for beryllium. Over the following decades,
however, it became clear that workers exposed to beryllium
levels well below the standard were falling sick. In the 1990s'
the DOE and OSHA began the time-consuming legal process of
changing their exposure limits for beryllium. Brush Wellman, the
nation's leading producer of the metal, hired Exponent, a Menlo
Park, Calif., consulting firm specializing in product defense.
Sharing authorship with Brush Wellman's scientists, these
consultants wrote a series of papers suggesting it was possible
that the size, surface area and number of beryllium particles
may be more important than previously thought in the development
of CBD. They also raised the hypothesis that skin exposure could
play a larger role in disease risk. The consultants concluded
that the current standard for beryllium might not be protective
but that more research was required before changing it.
After reviewing all the studies and
taking testimony from industry and independent scientists, the
DOE leadership in the later years of the Clinton administration
decided that although more research is always desirable, the
department had more than enough information to warrant immediate
implementation of a stricter standard for beryllium. We issued a
new rule, reducing the acceptable workplace exposure level by a
factor of 10. Although we could not prove that the lower limit
would eliminate the health risks, we chose a level that we
believed would prevent most cases of CBD and that was also
technologically feasible. This new standard, however, applies
only to DOE workers; workers in the private sector, who fall
under OSHA's umbrella, do not enjoy the same protection. In 1998
OSHA declared its intention to follow DOE's lead, but three
years later the agency dropped that initiative. In November 2002
the agency implicitly accepted the industry's arguments by
issuing a call for additional data on the relation of beryllium
disease to, among other things, the size, surface area and
number of particles and the extent of skin contact. That is
where matters stand today.
As it happens, most scientists believe
that beryllium also increases the risk of lung cancer; several
studies conducted by epidemiologists at the Centers for Disease
Control and Prevention support this conclusion. ]in 2002,
however, statisticians from another product-defense firm, Roth
Associates in Rockville, Md., and the University of Illinois
published a reanalysis of a 10-year-old CDC study. By changing
some key parameters, the authors raised the estimates for the
background rate of lung cancer so that the elevation caused by
beryllium was no longer statistically significant. (This
procedure is rather easily accomplished, whereas the
opposite--turning insignificance into significance--is extremely
difficult.) Brush Weilman and NGK Metals, a producer of
beryllium alloys, had funded the research. The new analysis was
published in Inhalation Toxicology, a peer-reviewed journal--not
one primarily focused on epidemiology but peer-reviewed
nonetheless--and the industry now touts its study as evidence
that everyone else is wrong.
This pattern is not unique to the
beryllium industry. Many other companies that produce hazardous
chemicals have hired researchers to dispute and reanalyze data
showing adverse health effects. Their conclusions are almost
always the same: the evidence is ambiguous, so regulatory action
is unwarranted. Out of the almost 3,000 chemicals produced in
large quantities (more than one million pounds annually), OSHA
enforces exposure limits for fewer than 500. In the past 10
years the agency has issued new standards for a grand total of
two chemicals; the vast majority of the others are still
"regulated" by voluntary standards set before 1971, when the
newly created agency adopted them uncritically and unchanged.
New science has had no impact on them. I conclude that
successive OSHA administrators have simply recognized that
establishing new standards is so time- and labor-intensive, and
will inevitably call forth such orchestrated opposition from
industry, that it is not worth expending the agency's limited
resources on the effort.
Emphasizing uncertainty on behalf of
big business has become a big business in itself. The
product-defense firms have become experienced and successful
consultants in epidemiology, biostatistics and toxicology. In
fact, it is now unusual for the science behind any proposed
public health or environmental regulation not to be challenged,
no matter how powerful the evidence. Currently representatives
of indoor tanning salons are hard at work disparaging the
designation of ultraviolet radiation as a cause of skin cancer.
Furthermore, the denial of scientific evidence and the
insistence on an impossible certainty are not limited to
business interests. For instance, some zealous environmentalists
remain adamantly opposed to food irradiation--the use of gamma
rays, x-rays or electron beams to kill microbes in meats and
produce--even though the benefits of the practice greatly
outweigh the risks.
THE POWER OF COMPANIES to influence and
distort research is also strong in the pharmaceutical industry.
Consider the Food and Drug Administration's belated clampdown on
phenylpropanolamine (PPA), the over-the-counter drug that was
widely used as a decongestant and appetite suppressant for
decades. Reports of hemorrhagic strokes in young women who had
taken a PPA-containing drug began circulating in the 1970s. Over
the next 20 years, the FDA raised questions about PPA's safety,
but the trade association representing the drug's
manufacturers--including Bayer, Sandoz (now part of Novartis),
Wyeth and GlaxoSmithKline--rejected the agency's concerns,
employing scientists and lobbyists to keep PPA on the market.
Eventually a compromise was reached that allowed the companies
to select an investigator and fund an epidemiological study
whose design would be approved by both the manufacturers and the
FDA. They chose the Yale University School of Medicine; in 1999
the study confirmed that PPA causes hemorrhagic stroke.
Did the manufacturers withdraw the
drug, which by then had annual sales of more than $500 million?
No. Instead they turned to the Weinberg Group, a product-defense
consulting firm based in Washington, D.C., to attack the study
and had their attorneys put the researchers through grueling
legal depositions. David A. Kessler, former head of the FDA and
now dean of the University of California at San Francisco School
of Medicine, said, "With the amount of hassle and harassment
that [the Yale scientists] had to endure, I'm sure the next time
they're asked to undertake something like this, they'll wonder
if it's worth the cost." The FDA finally advised manufacturers
to stop marketing PPA in November 2000. The agency estimates
that the chemical caused between 200 and 500 strokes a year
among 18- to 49-year-old people.
Or consider rofecoxib, more commonly
known as Vioxx, the once popular pain reliever made by Merck.
Even before the FDA approved Vioxx in May 1999, the agency had
reviewed data suggesting that the drug could increase the risk
of heart disease. Several independent scientists (that is, ones
not on Merck's payroll) also raised red flags, but for the most
part the FDA ignored them. Then, in early 2000, the results of a
clinical trial showed that participants who took Vioxx for an
average of nine months had five times the risk of heart attack
as those taking the comparison painkiller, naproxen (sold under
the brand name Aleve).
Merck's scientists faced a 'dilemma.
They could interpret this finding to mean either that Vioxx
increased heart attack risk by 400 percent or that naproxen
reduced the risk by an astounding 80 percent, making it about
three times as effective as aspirin in protecting the
cardiovascular system. Unsurprisingly, the :company's
researchers chose the latter interpretation. But Merck abruptly
turned ablaut and took Vioxx off the market last September when
another trial found that: participants taking the drug for more
than 18 months suffered twice as many heart attacks and strokes
as those taking a placebo. One FDA analyst estimated that Vioxx
caused between 88,000 and 139,000 heart attacks--30 to 40
percent of which were probably fatal--in the five years the drug
was on the market.
Although the Wall Street Journal has
reported that certain documents suggest that Merck executives
were aware of the increased risk of heart attacks, it is hard to
imagine that the company's scientists were deliberately
promoting a drug they knew was unsafe. At the same time, it is
hard to imagine they honestly thought naproxen reduced the risk
of heart attack by 80 percent. If they did, they should have
urged the government to pour it straight into the water supply.
It seems more likely that their allegiances were so tightly
linked with the products they worked on, as well as the
financial health of their employers, that their judgment became
fatally impaired. And the FDA? That agency has neither the legal
authority nor the resources to effectively identify the adverse
outcomes caused by drugs already on the market.
As a result, civil lawsuits have become
the primary means for protecting the public from unsafe drugs
and chemicals. Recent rulings of the U.S. Supreme Court,
however, have made it harder for plaintiffs to introduce
scientific testimony to support their cases. Under the
precedents set by Daubert v. Mertell Dow Pharmaceuticals and two
related rulings, federal trial judges are now required to
determine whether the testimony is reliable and relevant. What
began as a well-intentioned effort to improve the quality of
scientific evidence has had troubling consequences: according to
an analysis published in 2002 in the Journal of the American
Medical Association, federal judges have barred respected
researchers from testifying in drug lawsuits because their
evidence--such as medical case reports and toxicological studies
on animals-did not meet the strict new standards. Corporate
defendants have become increasingly emboldened to challenge any
expert testimony on the grounds that it is based on "junk
science."
INDUSTRY GROUPS have tried to
manipulate science no matter which political party controls the
government, but the efforts have grown more brazen since George
W. Bush became president. I believe it is fair to say that never
in our history have corporate interests been as successful as
they are today in shaping science policies to their desires. In
2002, for example, the Bush administration remade a committee
that advises the CDC on the issue of childhood lead poisoning.
Secretary of Health and Human Services Tommy Thompson replaced
prominent researchers with individuals more likely to side with
the lead industry. (One new member had testified on behalf of
the lead paint industry in a suit brought by the state of Rhode
Islatid to recover the costs of treating children with lead
poisoning and cleaning contaminated homes.) Since then, the CDC
has not moved to strengthen the federal standards for lead
poisoning despite research showing that even very low levels of
lead in the blood can sharply reduce a child's IQ.
What is more, this administration has
tried to facilitate and institutionalize the corporate strategy
of manufacturing uncertainty. Its most significant tool is the
Data Quality Act (DQA), a midnight rider attached to a 2001
appropriations bill and approved by Congress without hearings or
debate. The DQA authorized the development of guidelines for
"ensuring and maximizing the quality, objectivity, utility, and
integrity of information." This sounds harmless, even
beneficial; who wouldn't want to ensure the quality of
government-disseminated information? In practice, however,
industry groups use the DQA to slow or stop attempts at
regulation by undercutting scientific reports. The law gives
corporations an established procedure for killing or altering
government documents with which they do not agree. It has been
used by groups bankrolled by the oil industry to discredit the
National Assessment on Climate Change, a federal report on
global warming; by food industry interests to attack the World
Health Organization's dietary guidelines, which recommend lower
sugar intake to prevent obesity; and by the Salt Institute to
challenge the advice of the National Institutes of Health that
Americans should reduce their salt consumption.
Even better for industry would be a way
to control information before it becomes part of an official
government document. To accomplish this tantalizing goal, in
August 2003 the Office of Management and Budget (OMB) rolled out
a new proposal entitled "Peer Review and Information Quality."
Under the plan, all covered information would undergo some form
of peer review before being issued by a government agency, and
any information that might affect major regulations or that
could have a "substantial impact" on public policies or
private-sector decisions would be put through a cumbersome
system in which the information was reviewed by experts
independent of the agency. Because the proposed peer-review
process would exclude all scientists receiving grants or
contracts from the agency, it seemed designed to maximize the
ability of corporate interests to manufacture and magnify
scientific uncertainty.
Enough was enough. In November 2003 the
usually quiescent science community finally rose up in protest
at a meeting sponsored, at the OMB's request, by the National
Academy of Sciences. In the face of this opposition--dozens of
organizations fired off scathing letters to the White House--the
OMB retreated and implemented a less onerous program that did
not exclude the most qualified scientists from the peer-review
process.
A new regulatory paradigm is clearly
needed, but the Bush administration is heading in the wrong
direction. Instead of encouraging industry groups to revise the
reports of government scientists, agencies should be focusing
more scrutiny on the data and analyses provided by corporate
scientists and product-defense firms. And instead of allowing
uncertainty to be an excuse for inaction, regulators should
return to first principles: use the best science available but
do not demand certainty where it does not exist.
A good example of such an approach is
the program to provide compensation for weapons workers sickened
after exposure to radiation or chemicals at DOE sites. (I helped
to design the initiative, which was enacted by Congress in
2000.) Because it is impossible to definitively determine
whether a particular cancer has been caused by radiation
exposure, the program estimates probabilities based on the
cancer rates among survivors of the nuclear blasts at Hiroshima
and Nagasaki. The model is not perfect, but the estimates are as
accurate as the available data and methods allow.
In that case, we did the right thing.
Now it is time for industry to do the right thing. We need a
better balance between health and money.
Deceit and Denial: The Deadly Politics
of Industrial Pollution. Gerald Markowitz and David Rosner.
University of California Press, 2002.
Science for Judges I-III. Edited by
Margaret Berger. Journal of Low on Policy, Vols. 12-13;
2003-2005. Available online at
www.brooklaw.edu/students/journals/jlp.php
More information about the use of
scientific evidence in public policy is available at
www.DefendingScience.org
PHOTO (COLOR): DRUG COMPANIES fund most
of the research on the health risks of their products. All too
often the firms highlight studies showing that the drugs are
safe and downplay less reassuring results.
PHOTO (COLOR): CORPORATE HURDLES are
impeding the regulation of unsafe chemicals and drugs.
PHOTO (COLOR): GOVERNMENT AGENCEIS have
been slow to act even in cases where the evidence for stricter
regulation is overwhelming.
~~~~~~~~
By David Michaels
Photographs by Mindy Jones
DAVID MICHAELS is an epiclemiogist who
served as the U.S. Department of Energy's assistant secretary
for environment, safety and health from 1998 to 2001. He is
currently professor and associate chairman in the department of
environmental and occupational health at the George Washington
University School of Public Health and Health Services. |