Document ymEQJ8ZNnqgorxkZGQz5wpnYV

FILE NAME: Asbestos Mining (ASMI) DATE: 2000 DOC#: ASMI035 DOCUMENT DESCRIPTION: Journal Article from Archives of Environmental Health [Authors - Egilman & Reinert] To the Editor-- "Corruption of Previously Published Asbestos Research." The history of the corruption of research focused on the health effects of asbestos is well documented.1' ' One study, changed at the request of asbestos companies, appeared in the pages of the pre decessor to the Archives o f Environmental Health.* We are, therefore, writing this letter to correct the record with respect to the aforementioned study. in the early 1950s, the Quebec Asbestos Mining Association (QAMA1, an industry trade group, asked the Industrial Hygiene Foundation to perform a mortality study of asbestos miners in the Province of Quebec. In this study, which was drafted in 1957, investigators reported that the miners had a statistically significant excess of lung cancer associated with asbestosis. A por tion of this draft read as follows: "The number of lung cancer deaths combined with asbestosis is larger than would be expected in each cohort and in the combined cohorts. This difference is significant at the 95% level using the chi-square test of significance." The aforementioned data (i.e., the conclusion that lung cancer was related to asbestos exposure) were never published. In fact, the authors published the opposite conclusion! In a comment on the draft, Dr. Kenneth Smith, mediral director for the johns-Manville Corporation (i.e., one of the sponsoring companies), noted the following in a letter to Ivan Sabourin, an attor ney who worked for QAM A: "Hugh latkson and I have reviewed the condensation of the survey which was sent us. We have noted deletion of all references to the association of asbestosis and lung cancer tn this con densation. While wo believe that this information is of great scientific value, we can understand the desire of the QAMA to emphasize the exposure of the asbestos miner and not the cases of asbestosis. We are also In agreement with the deletion of the reference to smoking and lung cancer. It must be recognized, however, that this report will be subjected to criticism when pub lished because all other authors today correlate lung cancer to cases of asbestosis" emphasis added]. To achieve the (incorrect) conclusion desired by their rrirpnrafe sponsors, the authors manipulated the statis tics to conclude that there was no significant increased risk of lung cancer associated with asbestos work. The Ilanuary/February 2000 (Vol. 55 (No. 1 authors inrlurled workers without asbestosis in the study group (i.e., thus diluting the effect of the "heavi est" exposures), and they used an inappropriate control group to calculate the expected rate of lung cancers. Instead of using available lung-cancei rates from the eight rountips surrounding the asbestos mines, researchers used rates from the Province of Quebec. If expected rates were calculated from data from the eight surrounding counties, even with manipulation of the denominator a statistically significant excess would have been found (Table 1) In addition, the rate of lung cancer among nonasbestotics exposed to asbestos was greater than expect ed. Although this analysis was not performed in the original study, a chi-square analysis of the original data fo r th e T h etfo rd C o h o r t is re v e a lin g . A m o n g J,5 4 fe m in ers without asbestosis, 5 developed lung cancer between 1950 and 1955. In the eight counties adjacent to Thetford, 54 men developed lung cancer between 1950 and 1955 (the population of the counties in 195L was 97,600). The resulting relative risk was 7 55 ,p .0 )8 Table 2i). The data are qualified by the tart that Table t .--Comparison of Observed lung Cancer Cases with Expected lung Cancer Cases Variable 1C No t(. Totals ix p o se r/ NorH'VfTO'yt.ti 4 5,914 5.92 1 O b ^ rx t-iJ 14 t 7 ,S 4 (. 9 .' ,(.(>0 Ten t- w h\ IIH 4M ' 1U r f .l ? l( S o LC totals (6 0 4 5 0 1 5 ,9 1 9 -5 9 5 5 92r >4.(955 9 7 ,5 4 0 .6 4 7 ,6 0 (1 * RR = 2.55 p - . .0014 1 'Votes- I f = lung cancel, ami RK - relative risk 'Rounded to next whole number M lO M fci) ! I 75 Table 2. Com parison of Observed lu n g C an ce r Cases without Asbestos' in Thetford Cohort with Expected Lung Cancer Cases Variable Fxposen Nonexpo s/ Totj l s LC No LC Totals 5 1341 3.546 O baencd 54 9 7 ,5 4 6 9 7 .6 0 0 * 59 101,087 101.146' LC No LC Totals spec ieci 2 .0 6 8 4 3 6 i. 54 5.912 3 .5 4 6 ' 59 93156 97.545 07 9 7 .6 0 0 ' RR = 2 .5 5 ;;;- 03792 5 101.087 103.523' Votes: LC = lung cancer, and RR = relative risk. 'Round*1/! In nest w hole number diagnosis of asbestosis in this population may not have been accurate. In the draft, Braun speculated that asbestosis had been underdiagnosed in this population (perhaps by the corporate doctors to m inim ize com pensation payments). Therefore, in this group of nonasbestotics, some may have had fibrosis of the lung attrib utable to asbestos exposure. This study had a minimal impact on the medical lit erature, but it continues to influence asbestos litigation. One author referenced this study in a book written in 1960 to support the assertion that "asbestos had not been found to be carcinogenic "At that time. Dr. Smith wrote that it was clear to " all' researchers that asbestos caused lung cancer. Lawyers tor asbestos companies use the corrupted Braun and Fiuan xtudv to argue that the relationship between asbestos and Ling came is unclear or controversial-- as late as l% ( i. This i vintal circle of events, in which companies tbai list changed the Braun and Truan paper to suit their needs and now attempt to rely on the corrupted stuck to escape liabili tv in court, is ironic--tint not unique-- in the fusion oi asbestos litigation. References 1 cattleman HI. Asbeslus MetJual .aid W ants. Im m fnglewood Clitt's, NIJ: Preriti/e K i l l Lav, and Bus.ness I ` mi, > Ullienlieki D The silent i- Ihc asbestos imlas!-* and <m 'K v <,, pational c a n c c rcsenrt h a c. se sluth Am 1 Rubik H'-alth 1991,81:791 99 3. Hardy t t l . Ig iln u n D C urruption ol cKcupatioul mech. ni liter ature: Ihc asbestos example Am I Ind Med 1991, 01 11 i 4 Braun D, Truan T An eptdennologual slurb- nt iunsj r.iru c i in aslreslus miners Arch Ind Health 1958 1- .614-52. 5 lohnslone RT, M iller S. Occupaliona Diseases arid lndus-i:,d M lic ne. Philadelphia. PA VV.fi. 'aum lcrs ( o . 1960 David Steven Egilman, M.D., M.P.H. Clinical Assistant Prolessoi Brown Universilv Braintree, Massachusetts Alexander Reinert Cambridge, Massachusetts 76 Archives of Environmental Health