Make India Asbestos Free

Make India Asbestos Free
For Asbestos Free India

Journal of Ban Asbestos Network of India (BANI). Asbestos Free India campaign of BANI is inspired by trade union movement and right to health campaign. BANI has been working since 2000. It works with peoples movements, doctors, researchers and activists besides trade unions, human rights, environmental, consumer and public health groups. BANI demands criminal liability for companies and medico-legal remedy for victims.

Saturday, April 20, 2024

Remembering David Egilman, the medical scientist who remained on side of truth, public health against Pharmaceutical, Asbestos, Talc firms, radiation tests

Dr. David Egilman, a professor of family medicine and medical expert witness who helped some 600 trials involving corporate crimes including occupational and environmental health crimes died on April 2 at his home in Foxborough, Massachusetts, USA. The New York Times reported "David Egilman, Doctor Who Took On Drug Companies, Dies at 71". He was a recipient of the prestigious Collegium Ramazzini's Dr. Irving Selikoff Award for his studies and achievements which contributed to the protection of workers’ health and the environment. Mourning his death, the author of Asbestos: Medical and Legal Aspects, Dr. Barry Castleman said, “David Egilman was a passionate, courageous public health worker, confronting corporate polluters and the makers of dangerous drugs and chemicals and asbestos products.”  

On my return from the three-day international conference in September 2003 on "Canadian Asbestos: A Global Concern" in the Canadian Parliament, Ottawa, I first learnt about him when his paper entitled "Exposing the 'Myth' of ABC, 'Anything But Chrysotile': A Critique of the Canadian Asbestos Mining Industry and McGill University Chrysotile Studies was published in American Journal of Industrial Medicine in 2003. His paper critically evaluated published and unpublished studies funded by the Quebec Asbestos Mining Association (QAMA) and performed by researchers at McGill University.  He pointed out that QAMA-funded researchers propagated myths regarding Quebec-mined chrysotile asbestos being harmless. They manipulated data and used unsound sampling and analysis techniques to contend that chrysotile was "essentially innocuous." He concluded that these studies were used to promote the marketing and sales of asbestos. These dubious studies had a substantial effect on policy and occupational health litigation. Asbestos manufacturing companies and the government continue to use such discredited to promote the use of all kinds of asbestos including white chrysotile asbestos in developing countries like India. The writings of Dr. Egilman and his comrades all over the world paved the way for Canada to ban white chrysotile asbestos.    

Dr. Egilman also concluded that researchers who are complicit in such manipulation seem to be motivated by a variety of interests, including "a pre-existing ideological commitment to support corporate interests over worker or community interests. Conducting industry-friendly research can also anchor an academic career by guaranteeing the steady stream of funding necessary to stay afloat in the 'publish or perish' environment of the university."

Dr Egilman's conclusions are relevant to a misleading submission of March 2024 before India's National Green Tribunal wherein, Asbestos Fiber Cement Product Manufacturers Association, a cartel of asbestos based companies has referred to a “National Study on Occupational Safety, Health and Working Environment in Asbestos Cement Product Industries” from November, 2018 to February, 2019 covering 50 functional asbestos cement product industries of the country carried out by the Directorate General Factory Advice Service and Labour Institutes (DGFASLI) under the Ministry of Labour and Employment. Out of 2603 workers, 10 cases were found to be suspected cases of asbestos related disorders. In a paper entitled “Analysis of the Indian Government’s position on the use of asbestos and its health effects” published in Public Health Action (June 21, 2023), Dr. R. Singh and Prof. A. L. Frank have examined DGFASLI’s study. They have concluded that “This study has some potential limitations, including the possibility that disease latency could be a factor, as the presence of disease may only be revealed decades after exposure. Furthermore, there appears to be no record of external peer review by an organisation outside the one conducting the study.”

Notably, in its submission before the National Green Tribunal, India's Asbestos Fiber Cement Product Manufacturers Association refers to judgement by the Supreme Court in Consumer Education Resource Centre v. Union of India (1995) but omits significant part of the directions with regard to ILO resolution and the compensation to the certified victims. This dishonest and insincere approach of the asbestos companies and DGFASLI demonstrates "their pre-existing ideological commitment to support corporate interests over worker or community interests."   


Responding to a question about a question as to when did companies discover that they were exposing people to dangerous levels of asbestos, Dr. Egilman said, In an official report of Parliament in 1898 made by "Lady Inspectors," the discovery about workers getting sick from asbestos exposure came about. The first death from asbestos disease was reported to Parliament in England in 1906.  U.S. insurance and mining companies became aware of asbestos health hazards by 1918. Mr. Hoffman, an actuary with Prudential Insurance, wrote a paper for the Department of Treasury/U.S. Government called "Health Problems In the Dusty Trade" in 1918. In that paper he said, "In the experience of Canadian and American insurance companies, insurance is usually denied to asbestos-exposed workers, due to the health injurious nature of the work."  Asbestos companies in the U.S., along with some insurance companies, especially the Metropolitan Life Insurance Company (which served as "the pivot man") were coordinators for the companies.  They began to conspire to hide the health effects of asbestos from workers, customers and government agencies beginning in 1930. This conspiracy continues to date...."


In a paper entitled "The Origin and Development of the Asbestos Threshold Limit Value: Scientific Indifference and Corporate Influence", he and Alexander A. Reinert traced the historical development of the American Conference of Governmental Industrial Hygienists' asbestos exposure guideline. They demonstrate that the proposed guideline was known to be inadequate when it was first proposed, was severely criticized between 1946 and 1968, but nonetheless was promulgated annually and remained unchanged until 1971. The paper was published in International Journal of Social Determinants of Health and Health Services. WHO's recommendations illustrate that asbestos exposure is fatal at all levels, no level is safe for human health.


He researched misconduct and the marketing of toxic pharmaceuticals, silicone implants, radiation exposure, asbestos exposure and health in under-developing countries. “A physician’s oath,” he told Science, “never says to keep your mouth shut.” Writing about his work, Science journal wrote about his testimony in a lawsuit filed by 22 women who claimed to have contracted ovarian cancer from exposure to Johnson & Johnson baby powder. Dr. Egilman interviewed the women about their frequency and duration of talc use, and he factored in the levels of asbestos that outside scientists had found in samples of talc, which is sometimes mined from formations that also yield asbestos. He calculated the women's doses of the carcinogen to establish that their exposure had doubled their risk of ovarian cancer. After a 6-week trial, the jury awarded $4.69 billion to the 16 surviving women and the families of the six who had died. It was the largest award in Missouri's history. He was quoted saying, "As a doctor, I can treat one cancer patient at a time," he explained during a trial last year. "But by being here, I have the potential to save millions." He was critical of journals which publish "tainted results" of ghost writers. He had detected how companies draw up their own studies, and added the name of doctors by paying them for “seeding”. He underlined that corporate money and power corrupted science and intimidated scientists. He has been the Editor in Chief of the International Journal of Occupational and Environmental Health (IJOEH).  


It may be recalled that after the acquisition of IJOEH by UK-based Taylor & Francis, one of the largest publishers of academic journals from Maney Publishing in 2015, a peer-reviewed article by the journal’s former editor-in-chief Dr. Egilman was withdrawn because he had criticized USA's Union Carbide Corporation (UCC)’s efforts to oppose workers’ claims of asbestos exposure. In a rare move, the editorial board of the journal resigned in protest. The editorial board wrote, “We do not wish to be party to the apparent new direction that the journal appears to be moving towards, and will not be party to these developments". In a letter dated November 22, 2017 addressed to Ian Bannerman, Managing Director Taylor & Francis Journals, Prof. Arthur L. Frank wrote, "On behalf of all the members of the Editorial Board of the International Journal of Occupational and Environmental Health, I am submitting to you our group resignation from the Board. We have been unsatisfied with our interactions with you and Taylor & Francis, especially regarding the appointment process for the new Editor-in-Chief, and the unilateral withdraw of approved or printed articles done by the publishers. We do not wish to be party to the apparent new direction that the journal appears to be moving towards, and will not be party to these developments." The letter was written on behalf of the Editorial Board members: Aurora Aragon, Arthur L. Frank, Bhaswati Ganguli, Morris Greenberg, Fu Hua, James Huff, Tushar Kant Joshi, Barry S. Levy, Leslie London, David Madigan, Jock McCulloch, Rene Mendes, Iman Nuwayhid, Domyung Paek, Alison Reid, Ellen Rosskam, Vilma Sousa Santana,Ken Takahashi, Jukka Takala, Benedetto Terracini, Andrew Watterson and David Wegman. It was copied to Andrew Maier, the new editor.


In a letter signed by 30 past and present editorial members and the founding editor, it was stated that "IJOEH has stood in a class by itself in publishing critical analyses and challenges of improper corporate influence on the standards of practice and scientific literature in our field. Originally, we raised serious concern that the Editorial Board was never consulted or informed by T&F about the change of editors, replacing Dr. David Egilman with corporate consultant Dr. Andrew Maier. We wrote to the publisher on February 11 requesting to know the process and justification for changing editors of a scientific journal without involving the Editorial Board." 


Dr. Egilman worked on the history of the development of knowledge of warnings and health effects and the epistemology of scientific knowledge. His work as an expert witness uncovered many different types of corporate and government malfeasance. He fought for the release of sealed company documents uncovered during litigation. He had sought unsealing of documents pertaining to the serious harm produced by Merck’s painkiller, Vioxx, and Eli Lilly’s neuroleptic drug, Zyprexa and Oxycontin because the manufacturers had  concealed and misrepresented risks known to them from the public and regulatory agencies. He testified before the advisory committees of the US Food and Drug Administration (USFDA). He had testified before the US House Subcommittee on Energy and Commerce, the President’s Advisory Committee on Human Radiation Experiments. He played an instrumental role in publicizing a declassified memo from 1950 that warned of the risks involved in government radiation tests on humans. “If this is to be done in humans, I feel that those concerned in the Atomic Energy Commission would be subject to considerable criticism, as admittedly, this would have a little of the Buchenwald touch,” Dr. Joseph G. Hamilton, a professor at the University of California at Berkeley, wrote in the memo, referring to the Buchenwald concentration camp where Nazi doctors carried out horrific medical experiments on prisoners. In later years, the U.S. government apologized for the radiation tests in 1996. Dr. Egilman's father had experienced Holocaust. He struggled to ensure that the horrors of Nazi medical experimentation are never repeated again. Dr. Egilman was Editor of The Journal of Scientific Practice and Integrity. The name of the journal seems to define his stature.


"The legacy of Dr. Egilman is characterized by his profound dedication to public health, his unyielding pursuit of truth, and his enduring commitment to improving the lives of people around the globe" said Linda Reinstein, the founder of Asbestos Disease Awareness Organization (ADAO).


Drawing lessons from the scholarly work of Dr. Egilman, Ban Asbestos Network of India (BANI) demands that Indian government should review and rescind those policies which promote asbestos in any way, in order to prevent unacknowledged public health disaster due to asbestos related diseases. Indian agencies must create a Registry of the Victims of Asbestos Related Diseases to initiate the process of adequately compensating the victims of asbestos-related diseases. A database of asbestos asbestos laden buildings and products must be created at the earliest.

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