JANUARY/FEBRUARY 1998 · VOLUME 19 · NUMBERS 1 & 2

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E N V I R O N M E N T

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INTERNATIONAL SCIENTIFIC ORGANIZATIONS have long been important sources of reports about toxic substances. With the globalization of trade and information, organizations such as the World Health Organization (WHO) and the International Labor Organization (ILO) find themselves with new authority and influence -- and the subject of intensified industry lobbying campaigns. With the emergence of the World Trade Organization as a forum where governments can challenge other nations' occupational and environmental health regulations for not being based on "sound science," the pronouncements of these groups has taken on added significance. Their publications, long important for providing information especially to countries with scant public health resources, may now also be used to both misinform developing countries and to overturn worker and environmental protection measures in the industrialized world.

INTERNATIONAL PROGRAM ON CHEMICAL SAFETY

Industry has exerted especially strong influence at the International Program on Chemical Safety (IPCS), a program located at the World Health Organization in Geneva and jointly sponsored by WHO, ILO and the United Nations Environment Program. Professor Andrew Watterson reported in the British medical journal The Lancet in 1993 that chemical manufacturers ICI, Hoechst and DuPont wrote the first drafts of IPCS reports on chlorofluorocarbon refrigerants and the fungicide benomyl. He raised concerns over undisclosed conflicts of interest by corporate consultants on expert task groups assigned to write IPCS documents and reported that industry "observers" usually present at IPCS task group meetings were rarely offset by representatives of non-industrial, non-governmental organizations. The same year, U.S. government scientists found that the IPCS environmental health criteria document on methylene chloride was based on material drafted by officials from ICI and other manufacturers of the chemical. Scientists from the National Institute for Occupational Safety and Health (NIOSH) criticized the IPCS's failure to modify statements in the report to reflect opposing views within its expert panel. NIOSH decided to cease all participation in IPCS activities until IPCS established an objective process to develop criteria documents.

Also in 1993, Collegium Ramazzini, a respected international group of occupational health scientists, refused to review drafts of a IPCS criteria document on chrysotile asbestos which was prepared by "scientists with close ties to the asbestos industry." By refusing to become involved at a late stage in the process, the Collegium said in a letter that it intended to avoid associating itself with an IPSC report that was compromised by industry influence. The effort to issue a chrysotile report remained mired in controversy for years, and publication is finally expected this year.

In 1996, at the invitation of the German government, IPCS held a workshop in Berlin on Multiple Chemical Sensitivities (MCS), a condition which leaves victims subject to serious and disabling reactions to a wide range of chemicals. Led by corporate consultants and chemical industry "observers," the panel decided, by an unrecorded vote, to rename Multiple Chemical Sensitivities (MCS) "idiopathic environmental intolerances." Panel Chair Dr. Howard Kipen and Dr. Claudia Miller, both from the United States, were among those who objected to the name change. After the conference, corporate consultants began representing the workshop's anonymous and unreferenced conclusions and recommendations as WHO policy at medical meetings, in court documents and in media announcements. The industry-funded Environmental Sensitivities Research Institute then paid for the publication of the recommendations in a supplement to the journal Regulatory Toxicology and Pharmacology, without the knowledge of IPCS, which still has not published the workshop report. Chemical industry consultants drafted a position statement for the American Academy of Allergy, Asthma and Immunology, using the new chemical-free name of MCS and referring to the workshop as a WHO symposium.

A pattern of such events led 81 scientists in 1996 to send a strong letter to IPCS and its United Nations sponsors decrying the corporate influence. That in turn led the U.S. government agencies that had relations with IPCS to recommend, through the U.S. State Department, 12 specific changes in IPCS procedures. The WHO responded by drafting "declaration of interest" guidelines, including a disclosure form to be completed by participants in expert scientific panels. IPCS participated in this process and circulated the draft guidelines for comment in October of 1997.

In the meantime, IPCS sent a very incomplete third draft of its report on chrysotile asbestos to the expert panel charged with writing the final report. This was a more balanced and qualified group than the 1993 industry-dominated one, and it extensively revised the draft, adding much new material. WHO panel members persuaded the Canadian scientist selected by IPCS to chair the panel to step down. The sole observer at the week's end, Dr. Graham Gibbs, had listed himself as representing the fibers committee of the International Commission on Occupational Health. Because he was seen by the panel as representing the asbestos industry, Gibbs was asked to leave the room during the writing of the concluding parts of the report. The conclusions and recommendations of the panel, which were publicly released, will probably not be of help in promoting asbestos use.

INTERNATIONAL LABOR ORGANIZATION

In 1993, the International Fiber Safety Group (IFSG) approached the ILO to hold training workshops in Brazil and Mexico to train specialists in the reading of chest X-rays. IFSG offered to bear most of the cost of the Latin American workshops. IFSG was created as a result of agreements within the international asbestos industry, though its exclusive representation of asbestos interests was obscured by its name. IFSG's representative was Scott Houston, who actually worked in Quebec at the Asbestos Institute. Inside the ILO, longtime asbestos industry medical representative Dr. Michel Lesage liaised with IFSG. Lesage surprised participants at the Brazil conference by putting forward positions as a representative of the ILO -- a UN affiliated body established to advance workers' interests -- that mirrored those of the asbestos industry. The ICOH Scientific Committee on Fibers subsequently prepared a monograph on the hazards of fibrous materials that was sent out by the ILO to scientific reviewers in August 1997. Long-time experts on asbestos William Nicholson of Mt. Sinai School of Medicine, Morris Greenberg, a retired factory medical inspector from the United Kingdom and John Dement of Duke University were stunned to notice that the asbestos chapter was written by Dr. Jacques Dunnigan, the long-time former director for health and environment for the Asbestos Institute, and that the editor-in-chief was Dr. Graham Gibbs, the Canadian observer who had been asked to leave during the closing sessions of the IPCS task group meetings on chrysotile in 1996. Drs. Nicholson, Greenberg and Dement declined to review chapters of the draft ILO report, not wanting to have their names associated with it. Strong protests from unions in the United Kingdom, the Nordic countries and the United States followed, along with criticism from scientists.

In the face of this sharp criticism, the ILO soon withdrew the report from consideration as an ILO publication. The ILO went on to acknowledge that it is examining its practices to develop appropriate responses for requests for sponsorship and attendance at meetings arranged by others, and submission of documents to ILO arising from technical cooperation activities. ILO may redefine its relationships with such groups as ICOH and the Asbestos Institute.

ICOH Vice President Bengt Knave seemed surprised to learn of all this in January 1998. ICOH guidelines require that documents developed by scientific committees be submitted to the officers of ICOH before publication, and he insisted that no such report had been received by the officers. After reading the ILO letter to the Nordic unions describing the discredited report as a product of the ICOH, he agreed that, "If the name and reputation of ICOH have been improperly used in this matter, it falls to the officers of ICOH to sanction the responsible individuals, publicly set the record straight, and take steps to assure that similar things cannot recur in the future." The ICOH letterhead lists Dr. Michael Lesage as one of the organization's officers.

WORLD HEALTH ORGANIZATION

The problem of corporate scientist influence even appears to pervade the World Health Organization. In July 1997, copies of WHO draft reports called "Asbestos and Health" and "Asbestos and Housing" became available for technical review. Both report drafts read as if they had been written by the asbestos industry. The housing draft offered only the vaguest information on the hazards of building with asbestos-cement sheets and pipes; it did not warn of the need for special cutting tools equipped with suction hoods and high-efficiency dust capture. It said nothing to direct or encourage people to use safer substitute materials for asbestos-cement pipe and sheet products. The health report described high exposures to asbestos as largely a thing of the past, in complete disregard for the way asbestos products (at least 80 percent asbestos-cement) are made and used today in the perhaps 100 or more countries still using a lot of asbestos. Critiques of the reports sent to WHO and also posted on the Internet prompted replies from the WHO-Europe office in Copenhagen, where these reports originated. That office in turn sent copies to reviewers, including Dr. Morris Greenberg of the United Kingdom, who replied that the reports suffered from many errors of fact and imbalance. In a letter to WHO, Greenberg called for a "radical rethink of the project" and the allocation of "resources that WHO usually requires for major policy documents." He pleaded for a longer timetable for the review process, "for the reputation of the WHO." Dr. Philippe Grandjean, a Danish medical expert, urged WHO to emphasize the alternative materials that could be used instead of asbestos-cement. Alan Dalton, a leading union health and safety representative in Britain, pressed WHO to do better, noting that a recent editorial in The Lancet had lamented the decline in WHO's reputation for technical expertise.

NEXT: THE WORLD TRADE ORGANIZATION

THE ASBESTOS INDUSTRY may soon seek to take advantage of any international scientific support it can muster. Canada, the world's largest asbestos exporting country, has already said that it plans to challenge the 1996 French asbestos ban in the WTO as an unfair trade practice. Canada can be expected to argue that scientific evidence provides public health justification only for "controlled use" of asbestos, and that a full ban therefore unfairly discriminates against a Canadian product. If Canada were to win such a WTO challenge, France would have to change its rule or agree to accept annual countervailing trade sanctions or pay annual fines. The implications of the pending Canadian challenge are severe. At least nine European countries have national asbestos bans, and the European Trade Union Confederation is calling for a continent-wide ban on the substance.

Though the asbestos industry is prominent in this story, its methods can be expected to be applied by others. "The asbestos industry is relatively small compared to some industries affected by publications on toxic substances," wrote Robert Wages, president of the Oil, Chemical, and Atomic Workers in the United States, to the ILO. "I deal with some of the largest corporations in the world on a day-to-day basis. I have to wonder how hard it will be for the oil and chemical industries to engage in revisionist science to permit the wholesale exposure of workers to toxics of every variety."

The WHO's "Declaration of interest" guidelines -- which will require scientists participating in WHO expert panels to complete one-page forms disclosing possible conflicts of interest -- constitute a first, critical step in preventing business interests from hijacking international science and health organizations. Disclosure as required by the U.S. Environmental Protection Agency's Scientific Advisory Board, with the forms freely available to the public, would be a sensible practice for all the international science and health bodies to adopt.