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Dec 24 2013

Further evidence of asbestos impropriety at IARC, the World Health Organization’s cancer agency

Kathleen Ruff, RightOnCanada.ca

On 13 September 2011, the International Agency for Research on Cancer (IARC) submitted a paper, Estimating the asbestos-related lung cancer burden from mesothelioma mortality, to the British Journal of Cancer. The paper was revised on November 21, accepted on November 23 and published by the BJC in early 2012.

The corresponding author for the paper was Paolo Boffetta, an Italian scientist. Boffetta worked for many years for IARC in Lyon, France, before leaving in 2009 to become co-founder and Vice President of a consulting company with a fine name – the International Prevention Research Institute – and also located, conveniently, in Lyon, France. The consulting company quickly proved extremely successful on the financial level, with a turnover of 2 million euros in 2011 (US $ 2.7 million).

The four other authors of the IARC paper were V. McCormack, G. Byrnes and K. Straif of IARC and J. Peto, Senior Visiting Scientist at IARC and a member of IARC’s Scientific Advisory Board for its Uralasbest asbestos research project in Russia.

In the Conflict of interest statement, published with the IARC paper, the authors declared “no conflict of interest”.

In 2011, at the same time that he was co-writing IARC’s paper on asbestos, however, Boffetta was being paid by an Italian asbestos company to help it to defeat charges of criminal negligence, causing the deaths of a dozen workers, who died from mesothelioma after being exposed to asbestos used at the company’s Montefibre factory in Italy.

IARC’s Declaration of Interests Form states:

“To ensure the highest integrity and public confidence in its activities, IARC/WHO requires that experts serving in an advisory role disclose any circumstances that could give rise to a potential conflict of interest related to the subject of the activity in which they will be involved. All experts serving in an advisory role must disclose any circumstances that could represent a potential conflict of interest (i.e. any interest that may affect, or may reasonably be perceived to affect, the expert’s objectivity and independence). You must disclose on this Declaration of Interest (DOI) form any financial, professional or other interest relevant to the subject of the work.

Specifically, scientists are asked to disclose whether, within the past 4 years, they have received remuneration from a commercial entity or other organization with an interest related to the subject of the meeting or work.

Boffetta was playing a more important role than an advisor to IARC. He was co-writing IARC’s article.

“To ensure the highest integrity and public confidence in its activities”, as it claims to do, IARC had a deep obligation to ensure there was no conflict of interest.

Disturbing questions

Why was a non-IARC scientist, who was running a private consulting company and involved in a financial relationship with an asbestos company, invited by IARC to be a co-author of the IARC article on asbestos risk?

Why was this conflict of interest not disclosed in the IARC article?

 According to Boffetta, continued exposure to asbestos does not cause harm to health

Boffetta was paid by Montefibre to testify in court as an expert witness on the company’s behalf, along with Carlo La Vecchia, Director of Reseach at Boffetta’s consulting company. The pair testified in court in support of the company’s argument that if workers had been exposed to asbestos in the distant past, then it did not matter if they were subsequently exposed to asbestos. According to the hired pair of scientists, repeated, subsequent doses of asbestos do not cause further harm to workers, so there should be no consequences to the company for having continued to expose its workers to asbestos over the ensuing decades.

According to this inventive argument, the representatives of the company, who were accused of causing the asbestos-related deaths of the workers, should all be acquitted. Only factory managers from back in the 1950s and 1960s, at the time of the workers’ first exposure, should be held responsible. Since these factory managers were all now dead, the case should conveniently be dismissed and the company officials allowed to wash their hands of the workers’ deaths.

According to Boffetta, once a worker had been exposed to asbestos, they might as well continue to be exposed for the rest of their lives, with no liability for the employer.

 Boffetta assisted the company in other ways

In addition to acting as witnesses for the company, Boffetta and La Vecchia assisted the company in other ways.

While an appeal of the court case was pending, Boffetta and La Vecchia published an article in the European Journal of Cancer Prevention, entitled Role of stopping exposure and recent exposure to asbestos in the risk of mesothelioma, which, they said, was a review of the scientific literature.

The article endorsed the creative position that the company had put forward in court. According to Boffetta and La Vecchia, their review of the scientific literature showed “consistent evidence that for workers occupationally exposed in the distant past, the risk of mesothelioma is not appreciably influenced by subsequent exposures. Further, stopping exposure does not materially modify the risk of mesothelioma over subsequent decades.”

The article is contaminated by serious scientific and ethical flaws.

First of all, the “review of the scientific literature” carried out by Boffetta and La Vecchia was selectively restricted to a limited number papers. Their “review” carefully omits the scientific literature that shows that continued, increased exposure to asbestos does, in fact, cause additional harm to workers. The article is biased and the bias served the interests of the asbestos company that had paid them.

Italian epidemiologist Dario Mirabelli notes that Boffetta and La Vecchia considered “a very limited number of studies and the results of those that were considered, were selectively reported. For example, they cite our most recent article on mortality among workers in the Eternit plant in Casale Monferrato, but they do not cite our main result, which is that mesothelioma mortality is directly proportional to the duration of exposure asbestos.”

In violation of ethical requirements, Boffetta and La Vecchia declared in this article that they had “no conflicts of interest”. They omitted to declare the fact that they had been hired and paid by Montefibre to put forward this exact argument.

Further adding to the insalubrious context, the article was published at the speed of lightning. Astonishingly, the article was submitted to the European Journal of Cancer Prevention on September 28, 2011 and accepted four days later on October 2, 2011 – a Sunday. It is not irrelevant that the authors had inside influence at the journal. La Vecchia is one of the journal’s two editors.

This unusual handling of the article permitted it to be published prior to the appeal being heard in court. If the article had been published after the appeal, the article would not have served the company’s interests in court.

Boffetta and IARC

What was Boffetta’s role in the IARC article on asbestos? The IARC article is contaminated by similar scientific and ethical flaws as Boffetta’s article, which claimed that continued exposure to asbestos does not cause harm to health and which he was writing at the same time as the IARC article.

The IARC article has been severely criticized by scientists for putting forward inaccurate and misleading information that serves the interests of the asbestos industry by minimizing and creating doubt about harm caused by chrysotile asbestos and by appearing to support “controlled use” of asbestos.

As just one example, the article cites data from 2000 by Hodgson and Darnton regarding potency differences between chrysotile and amphibole asbestos to cause mesothelioma and lung cancer. Hodgson and Darnton withdrew this data in 2009 and replaced it with revised estimates that showed significantly lower potency differences between chrysotile and amphibole asbestos. But, inexplicably, the IARC article put forward the old, inaccurate data which is preferred by the asbestos industry.

It has always been difficult to believe that the inaccurate data put foward in the IARC article was due to gross incompetence on the part of IARC. It is unlikely that IARC could show such incompetence. The only alternative explanation is industry contamination of IARC’s work.

One has to question why IARC selected Boffetta to be a leading co-author of the article. He was Vice-President of a private, lucrative consulting company and was busy hiring himself out to industry groups, such as the American Chemistry Council and the Italian asbestos company, that make huge profits from selling toxic products or who are seeking to avoid responsibility for victims who have died because of the company’s earlier use of a deadly substance.

Epidemiology: dangerous liaisons between scientists and toxic industries

In an important article, Epidémiologie: des liaisons dangereuses, published by the French newspaper Le Monde on December 18, 2013, journalist Stéphane Foucart exposes the close financial links between Boffetta and toxic industries. Over and over again, Boffetta has been financed by industry groups and corporations. Over and over again, Boffetta comes up with conclusions, favourable to the industry, that deny or cast doubt on harm caused by the company’s product, whether it be the carcinogenicity of the dioxin TCDD; whether it be the link between leukemia and formaldehyde exposure; whether it be the carcinogenicity of diesel fumes; whether it be the harm caused by continued exposure to asbestos; whether it be harm caused by pollution from a major steel plant.

Boffetta’s  findings, while favourable to the interests of the industry group financing him, are contrary to the overwhelming consensus of independent, reputable scientists.

Many of Boffetta’s articles, with their industry-favourable findings have been published in the journal, Critical Reviews in Toxicology. The Editor in Chief of this journal, Roger McClellan, was formerly the Chief Scientist and then Director of the Chemical Industry Institute for Toxicology. McClellan has served as an expert on behalf of an asbestos company, Union Carbide and has written and published articles with industry financed scientists seeking to cast doubt on the carcinogenicity of diesel exhaust.

In a letter of November 25, 2013, a complaint was submitted to McClellan regarding an article he published in his journal, which promoted continued use of chrysotile asbestos. In the article, David Bernstein and his co-writers gave false information regarding their relationship with an asbestos lobby organisation and failed to disclose their close ties to the asbestos industry. In their letter, scientists and health advocates called on McClellan to withdraw the article because of the serious ethical violations.

McClellan did not respond. His journal is apparently not concerned about improper and undisclosed industry influence over scientific articles.

When scientists become mercenaries for toxic industries

Boffetta is expected to become the next head of France’s leading epidemiology institute, the Centre for Research in Epidemiology and Population Health (CESP). The article in Le Monde descibes how Boffetta’s appointment is being challenged by a section of the scientific community because of his close relationship with polluting industries. While in the early part of his career, Boffetta was respected, he has since changed and has now become an industry mercenary, say the scientists.

When scientists sell their integrity to become highly paid consultants for toxic industries, they become a threat to science and a danger to the health of people and the environment.

Who will hold them accountable? It is significant that most of the scientists interviewed by Le Monde asked to remain anonymous. Challenging a powerful figure in the world of science can be harmful to one’s career. Others in France’s scientific community chose to close their eyes to any problem and to support Boffetta’s appointment as head of France’s leading epidemiology institute. Apparently, scientific and ethical integrity are not requirements of the position.

A common reaction of people involved in any institution, whether motivated by self preservation or by misplaced loyalty, is to turn a blind eye to improprieties committed by the institution. Whether it be IARC or CESP, true loyalty to the institution means finding the courage to hold it accountable and not allowing it to lose its integrity, without which the institution is worth nothing.

Let us hope that scientists involved in IARC and CESP will find that courage.

If a water supply is poisoned and people are harmed and die, this is rightly considered to be criminal.

When scientific information is poisoned, at the payment of and to the benefit of toxic industries, people are harmed and die. We have seen many examples of this tragic scenario.

Both the scientific community and the public at large have a responsibility to protect the integrity of science. Will they do so?