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27 December 2013

How the Industry Embarked on a Strategy to Give Chrysotile Asbestos a Clean Bill of Health - Part 1

This article on the chrysotile asbestos industry, which is alive and well, is posted in its entirety in two parts.

The anatomy of deadly product defence campaigns
by Rory O’Neill, Editor, Hazards, December 2013

Some scientific hired guns try to hide their industry ties; others flaunt them. Either way cash-for-science can be very bad news for your health. Hazards editor Rory O’Neill follows the money.

Take one deliberately undercooked cancer experiment, publish a scientific paper to promote its academically ridiculed findings, and go on a world tour to publicise its conclusions, and what do you get? In the case of Dr David Bernstein, the asbestos industry’s go-to scientist, the answer is several million dollars.

For the Switzerland-based US toxicologist, his role as the chief scientific propagandist for the asbestos industry worldwide has been as lucrative as it has been suspect.

One 2003 study alone was financed with $1 million from the Chrysotile Institute, at the time the lead body for the industry lobby worldwide.1 It formed the basis of what David Egilman, editor-in-chief of the International Journal of Occupational and Environmental Health (IJOEH), called the asbestos industry’s enduring ABC – Anything But Chrysotile – myth.2 The Bernstein paper argued that because chrysotile was less “biopersistent” than other forms of asbestos, it could be used safely.

No matter that the International Agency for Research on Cancer (IARC)3 and scientists not in the pay of the industry believe that all forms of asbestos, including chrysotile, are unquestionably human carcinogens.

The industry though needed to convince the world that chrysotile was different. Its survival plan required it to defend chrysotile markets and that meant questioning the cancer link. Big Asbestos has nowhere else to go - for two decades chrysotile has been the only form of asbestos traded. It has comprised 95 per cent of all asbestos used over the past century.

So the industry embarked on a four step strategy to give chrysotile asbestos a clean bill of health.

1. Buy some evidence

Following publication of the $1m paper in 2003, Bernstein’s relationship with the chrysotile – asbestos – industry flourished. More papers followed on the biopersistence theme, backed by the International Chrysotile Association (ICA). The companies chipped in too. He banked $850,000 for papers produced for just one asbestos defendant, Georgia Pacific (Hazards 124).

Bernstein maintains that chrysotile is all but harmless if used under controlled conditions. But his views are at odds with accepted scientific opinion, something even Bernstein conceded. Under cross examination in an October 2007 US court case, he was asked by Richard Nemeroff, an asbestos victim’s attorney: “In all the years… since you published your work, nobody, not one scientific organisation, not one scientific body, not one government, not one agency, not one anyone has accepted your view of chrysotile as you’ve explained it to this jury today; isn’t that correct?”

Bernstein responded: “That is correct.”

For the companies bankrolling Bernstein’s work, it was pure economics. In early 2005, US building products manufacturer Georgia Pacific had found itself facing nearly $1 billion in chrysotile-related disease liabilities. A $6 million investment in helpful research made cash sense.

After the Georgia Pacific project, Bernstein was paid about $200,000 by ICA to revisit the issue. This result was a 2013 paper in the journal Critical Reviews in Toxicology.4 While admitting “heavy and prolonged exposure to chrysotile can produce lung cancer,” it concluded: “The importance of the present and other similar reviews is that the studies they report show that low exposures to chrysotile do not present a detectable risk to health. Since total dose over time decides the likelihood of disease occurrence and progression, they also suggest that the risk of an adverse outcome may be low with even high exposures experienced over a short duration.”

It was a very familiar refrain. A 2006 paper in the journal Regulatory Toxicology and Pharmacology,5 again with Bernstein as the lead author, reached an uncannily similar conclusion. “The value of the present and other similar studies is that they show that low exposures to pure chrysotile do not present a detectable risk to health. Since total dose over time decides the likelihood of disease occurrence and progression, they also suggest that the risk of an adverse outcome may be low if even any high exposures experienced were of short duration.”

This paper was reproduced on the website of the Chrysotile Institute – which, in its previous guise as the Asbestos Institute, co-financed the work.

[Photo at right:]  STUDY DISSECTED David Bernstein said his rat experiments proved low level exposures to chrysotile or high level exposures for short periods “do not present a detectable risk to health.” But his experiments were seriously flawed and ran for just five days, not the two years recommended for studies of cancer risks from fibres.

Critics believe the research started with its off-the-shelf conclusion, distancing chrysotile from the now commercially irrelevant other forms of asbestos, then engineered the evidence to fit. David Egilman and others have eviscerated, in court and in print, the laboratory rat experiments undertaken by Bernstein to underpin his almost universally derided opinion.

Egilman, rebutting a defence of Bernstein’s work byUK professor Ken Donaldson, points out the standard protocol for testing fibres for carcinogenicity in humans is a two-year animal inhalation study - not a five-day study of the sort overseen by Bernstein.6 Although the two-year test was endorsed by an expert government panel - of which Bernstein was a member - in the mid-1990s, Bernstein decided the five-day test would suffice.

Egilman, a Brown University professor who has been an expert witness for asbestos plaintiffs, noted “the key question is… do the fibres persist long enough to induce the disease (eg. induction of mutations when cancer is the outcome of interest)? The answer to this question is clearly yes.”

2. Have a promotional tour

David Bernstein has clocked up the air miles. Financed by asbestos trade groups, he has appeared worldwide to sell the chrysotile “safe use” argument. Since authoring the $1m biopersistence paper for the industry in 2003, he’s taken the message to countries including Indonesia, Thailand, Brazil, Malaysia, the Philippines, Colombia and India.

The 25 January 2013 publication of the Critical Reviews in Toxicology paper manufactured an opportunity for another product defence road trip.

Minutes of ICA’s December 2012 executive meeting note the body’s “determination that ICA make known the study to everyone at local [and] international levels as well as to competent authorities of international organisation like ILO, WHO, IARC etc. As proposed by Chairman Mr Leblond, members have accepted that financial resources be authorised accordingly and that a good action plan be prepared as soon as possible in order that ICA be well prepared.”

[photo at right:] TROUBLING PICTURE While asbestos industry favourite David Bernstein was willing to tell countries importing chrysotile their workers could use it safely in industrial quantities, his technicians - handling minute samples of the same fibres - wore protective suits, disposable masks and full-face positive pressure masks on top.

The asbestos industry was going to get its money’s worth from its 10-year, multimillion dollar investment. Such was the industry’s eagerness to cash in on its latest purchase, it ensured Bernstein’s Critical Reviews in Toxicology paper made a public appearance before it was even published.

On 23 January 2013, it surfaced at a European Parliament committee meeting in Strasbourg, France, where Roger Helmer, an elected member of the European Parliament, used it in an effort to frustrate plans to tighten asbestos regulation. Helmer, a member of the right wing UK Independence Party, said the paper showed how chrysotile had been unjustly “demonised.”

ICA president Jean-Marc Leblond gave the paper its first post-publication airing, to convince the government of Pakistan not to ban asbestos. A 31 January 2013 letter to authorities in the country noted: “The number of scientific studies demonstrating that chrysotile can and is being used safely, ie. at low exposures it does not present a detectable risk to health, is numerous. The most recent instance of a peer-reviewed study of paramount relevance to your deliberations is entitled ‘Health risk of chrysotile revisted’ [sic] and is published in Issue 2 of Volume 43 of Critical Reviews in Toxicology (February-March 2013).”

The letter concludes “we are persuaded the scientific evidence is overwhelming which supports the safe and responsible use of chrysotile and that there is no basis for prohibiting its use in today's high density products.”
[photo at left:] BREATH TAKING The International Chrysotile Association, urging the authorities in Pakistan to step back from introducing a ban on their cancerous product, said “the scientific evidence is overwhelming which supports the safe and responsible use of chrysotile and that there is no basis for prohibiting its use.” This worker sawing asbestos in Pakistan, and the group of children looking on, would be better protected by the use of safer alternatives.

For evidence, Leblond’s letter lifts wholesale Bernstein’s one stop clean bill of health for chrysotile. “The importance of the present and other similar reviews is that the studies they report show that low exposures to chrysotile do not present a detectable risk to health. Since total dose over time decides the likelihood of disease occurrence and progression, they also suggest that the risk of an adverse outcome may be low with even high exposures experienced over a short duration.”

It was a 64-word mantra the industry had paid for and would pay for again, to give it licence to dust off an old purchase as new “scientific” evidence.

Kathleen Ruff, author of Exporting Harm, a 2008 investigation of the asbestos industry’s marketing drive, said the Critical Reviews in Toxicology paper was also central to the industry’s campaign that in May 2013 ensured chrysotile was not added the Rotterdam Convention’s right-to-know list of highly toxic exports.

Bernstein billed ICA for $6,600 for his “services rendered” in packaging the paper for the convention meeting. The ICA submission to the meeting was headlined “the crusade against chrysotile must end.” At the meeting, Bernstein’s paper was their trump card.

While in the Philippines on a November 2013 ICA-financed promotional visit, Bernstein told the Business Mirror that chrysotile asbestos is “a very valuable product” and using the better the devil you know defence said that it poses “little risk to the people’s health and environment”. Criticising those calling for ban, he said potential substitutes were more hazardous and less suitable. “Logically from a health point of view, you may be introducing something which is worse or far worse,” he said, adding that in tropical countries like the Philippines, the alternatives “are more expensive and less efficient.”

According to Ruff, a human rights expert based at Canada’s Rideau Institute: “No professional salesman could have done a better job.”

Yet Bernstein’s asbestos industry favoured line on cancer risks from chrysotile, bans and the relative safety of substitutes – cited by ICA head Jean-Marc Leblond in his letter to the authorities in Pakistan – had been dismissed unequivocally at the May 2013 Rotterdam Convention meeting.

The official report of the meeting, which was attended by Leblond, notes: “The representative of the World Health Organisation (WHO) reported that the International Agency for Research on Cancer (IARC) had concluded that all forms of asbestos, including chrysotile, were carcinogenic to humans, the latest information having been published in 2012.

“She said that owing to the widespread use of chrysotile in building materials and other asbestos products it was not possible to prevent the exposure of workers and the general public. Furthermore, the chemical could not be used safely owing to the way in which products containing it were produced and handled and degraded in situ, as well as the challenges that they presented in decommissioning and subsequent waste management. She added that WHO and IARC had conducted an evaluation of fibrous chrysotile asbestos substitutes and had concluded that safer alternatives were available.”

But that wasn’t going to stop Bernstein. He was working from the same script on the next stop on his global asbestos ICA sales tour. This took him to New Delhi, India - the world’s largest asbestos importer - on 3-4 December 2013.

This time though, the asbestos peddlers were beaten to the punch. The Occupational and Environmental Health Network of India (OEHNI) coordinated the international response to the latest stage of an asbestos industry promotional drive that has seen imports of chrysotile asbestos to India nearly double in six years.

A 2 December 2013 letter condemning this aggressive marketing of chrysotile in the country, signed by over 300 eminent experts from 36 countries, had been sent to India’s health, labour and environment ministers. The letter noted: “The International Chrysotile Association and the Asbestos Cement Products' Manufacturers Association of India (ACPMA) are disseminating deadly, deceptive misinformation about chrysotile asbestos, that will cause suffering and loss of life for years to come.” It said “not a single reputable agency in the world” supports the ICA claim that chrysotile can be used safely.

OEHNI’s Mohit Gupta said that “since 1960, India has used over 7 million tonnes of asbestos and that in 2013 usage is predicted to exceed 500,000 tonnes.” India imports more asbestos than any other country, with imports up from 253,382 tonnes in 2006 to 473,240 tonnes in 2012.

But the industry was now facing opposition from scientific and medical heavyweights, backed by an increasingly effective global network of campaigners determined to secure a global ban on chrysotile, the only form of asbestos still traded.

Big Asbestos needed a new plan.

References (part 1)

1 DM Bernstein, R Rogers and P Smith. The biopersistence of Canadian chrysotile asbestos following inhalation, Inhalation Toxicology, volume 15, number 13, pages 1247-1274, January 2003.

2 D Egilman, C Fehnel, SR Bohme. Exposing the "myth" of ABC, "anything but chrysotile": a critique of the Canadian asbestos mining industry and McGill University chrysotile studies, American Journal of Industrial Medicine, volume 44, number 5, pages 540-557, November 2003.

3 A Review of Human Carcinogens: Arsenic, Metals, Fibres, and Dusts, IARC Monograph, volume 100C, 2012.

4 D Bernstein and others. Health hazards of chrysotile revisited, Critical Reviews in Toxicology, volume 43, number 2, pages 154-183, 2013.

5 DM Bernstein and JA Hoskins. The health effects of chrysotile: Current perspective based upon recent data, Regulatory Toxicology and Pharmacology, volume 45, issue 3, pages 252–264, August 2006.

6 K Donaldson, G Oberdorster. Continued controversy on chrysotile biopersistence,IJOEH, volume 17, number 1, pages 98-99, 2011; and rebuttal by David Egilman pages 99-102.

See next post for Part 2.

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