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       Hazards special online report, March 2016
How the asbestos industry turns to British scientists
Britain has history on asbestos. It has the highest death rates from asbestos cancers in the world. It is also home to some of the industry’s most relied-upon scientists. Hazards editor Rory O’Neill investigates.

British scientists have shown a remarkable willingness to defend chrysotile – the most common and last remaining form of asbestos in commercial use - although some have proved less keen to declare their links to the industry, a Hazards investigation has established. It reveals the impact of this research is being felt at home and abroad.

When concerns were raised that workers at the Balangero chrysotile asbestos mine in northern Italy and nearby residents had developed cancers as a result of exposure to its dust, British scientists stepped in to question the link.

Two of the four authors of a 2015 Epidemiology, Biostatistics and Public Health (EBPH) paper – Fred Pooley and John Hoskins – are UK-based scientists. Their contribution, Critical reappraisal of Balangero chrysotile and mesothelioma risk,(1) first disputed whether most of the cancers were asbestos cancer at all. In a belt-and-braces defence, it then claimed the “alleged” cancers were anyway caused by exposure to other forms of asbestos, adding there was “good evidence” to support this claim.

The paper directly implicated three other types of asbestos, noting: “All the evidence suggests that crocidolite, amosite and tremolite are responsible for the alleged mesothelioma cases at Balangero.”

But evidence soon emerged casting doubt on their claims and leading some to question their motives. 

Eminently wrong

Two issues after the EBPH paper was published, the journal published an erratum.(2) This revealed the previously undeclared ties of Pooley and Hoskins to the asbestos lobby. The erratum noted: “Pooley FD, Emeritus Professor, University of Cardiff, has acted as a consultant to asbestos companies.”



SAYS WHO Royal Society of Chemistry fellow John Hoskins failed to own up to his chrysotile industry ties. But he claimed at an industry ‘scientific workshop’ in Vietnam that the World Health Organisation (WHO) doesn’t support an end to chrysotile use, when this is palpably untrue. more

It said Hoskins, a Royal Society of Chemistry fellow, member of the RCS toxicology committee and an independent toxicologist, has links to what was a major lobbying organisation for the global asbestos industry. It noted: “Hoskins JA has attended and spoken at several meetings on behalf of the Chrysotile Institute.”

The same issue of EBPH included a letter to the editor(3) highly critical of the paper, authored by Corrado Magnani of the Cancer Epidemiology Unit at the University of Eastern Piedmont and others. This stated: “The explicit purpose of this paper is to exclude the role of chrysotile in the mesothelioma epidemics among workers of the former San Vittore mine (Amiantifera di Balangero) and inhabitants in the Balangero area.”

In doing so, the authors of the Balangero paper had been guilty of “gross mistakes”, the letter stated, adding: “The paper is full of statements that have no substance and lack support of evidence.” Listing a succession of errors, the authors of the letter concluded it “is an example of a poor quality paper, with no scientific content, that a scientific journal should never publish.” A conflict of interest statement noted six of the eight authors of the letter critical of the Illgren paper had “served as expert witness for the public prosecutor in asbestos related cases,” with three prosecution expert witnesses in “a trial on asbestos related diseases in Balangero workforce and residents.”

In the next issue of EBPH, the editors-in-chief, Stefania Boccia and Carlo La Vecchia, had to pen another erratum.(4) The authors, in their eagerness to deflect blame for the cancer from chrysotile, had noted: “Crocidolite and amosite (asbestos) were also transferred to Balangero in jute bags.”

But as Magnani and his co-authors had pointed out, the source cited in the paper to support this claim included no such evidence, with the erratum written by the editors-in-chief of the journal stating it was an “erroneous claim.”

Human rights campaigner Kathleen Ruff, who has uncovered a succession of similar chrysotile-absolving papers with undeclared asbestos industry links, noted: “Asbestos interests spend tens of millions of dollars for scientists to write articles that deny harm caused by chrysotile asbestos and claim that ‘anything but chrysotile (ABC)(5) has caused harm.

“Workers and populations who are exposed to harm from chrysotile asbestos do not have tens of millions of dollars to spend to defend their right to health. Instead, they depend on scientists and scientific organisations to show integrity and uphold scientific and ethical standards.”

She said the authors of the Balangero paper “apparently, refuse to admit that they published false information. Consequently, instead of the authors publishing this second correction in their names, as would be normal for any responsible authors, the two editors-in-chief have published the correction as a statement from the editors-in-chief.”

This was a big stakes game that went way beyond a scientific and ethical dispute; it also had at its core alleged criminal culpability for asbestos-related deaths where defendants had included top directors of the multinational Eternit, which owned Balangero when it was the last active asbestos mine in Europe. It wasn’t just chrysotile in the dock; it was also the billionaire Swiss industrialist behind the company, Stephan Schmidheiny.

At home with asbestos

Until the late 1970s, Britain was the hub of the global asbestos industry’s marketing and “product defence” activities. In 1957, the UK industry created the Asbestosis Research Council (ARC) under the umbrella of Edinburgh’s Institute of Occupational Medicine (IOM). A decade later, the industry created the Asbestos Information Council (AIC), to handle publicity and lobbying.(6) It was based in the London headquarters of Hill & Knowlton, the world’s largest public relations (PR) firm.

Hill and Knowlton had a similarly close association with the US asbestos industry. Under its guidance, the industry bankrolled the New York-based Asbestos Information Association, headed by a former Hill and Knowlton staffer. The firm knew it has a track record of interest to the asbestos lobby. It had defended Big Tobacco against smoking-related disease claims, using what became known as the “tobacco industry playbook” (Hazards 103).

It was a product defence strategy the PR giant employed to create doubt and confusion on the evidence of health risks. And it was a strategy quickly and enthusiastically embraced by the asbestos industry.(7) And it worked. An undated Hill & Knowlton internal list of eight success stories had asbestos at number 3. Under ‘results’, it noted: “Despite the validity of many of the claims made against asbestos and the efforts of various groups to eliminate the material from our society, the industry still exists and is producing products that are safe” (Hazards 132).

The industry’s mission was to contest findings of damaging studies. It didn’t need to disprove them, just cast doubt on the findings. This would be enough to stall regulatory action and derail compensation claims from those dying as a result of their exposures.

Chrysotile – whiter than white?
Why is asbestos still in use? Because someone is selling it. High profile events orchestrated by the International Chrysotile Association (ICA) in Asia, Africa and Latin America set out to convince government ministers, regulators and the media their product is safe as houses. That’s where John Hoskins came in. more

An investigation by the US Center for Public Integrity reported in February 2016 that Ford spent $40m on studies to question the link between asbestos brake linings and cancer. In terms of its bottom line, if not its responsibility, it was money well spent.

According to David Egilman, a clinical professor of family medicine at Brown University and editor of the International Journal of Occupational and Environmental Health: “They can throw a lot of things at the wall and hope something sticks with the jury. It forces people like me or other scientists to try to clean up each thing that was thrown at the wall, one at a time. And by the end of the day, that could be confusing to a jury or judge.”

Several names crop up with regularity in articles questioning links between chrysotile and asbestos cancers, particularly mesothelioma. David Bernstein (Hazards 124), a US toxicologist based in Geneva, is the asbestos industry’s favourite hired gun and the recipient of several million dollars from the industry. The now moribund Canadian Chrysotile Institute leant so frequently on his expertise, it included his CV on its website.

But many of Bernstein’s co-authors hail from closer to home.

Product defence

Fred Pooley, John Hoskins, Allen Gibbs, a pathologist from the University of Wales College of Medicine and Ken Donaldson - a particle toxicologist with a long association with the Institute of Occupational Medicine and Edinburgh University and linked to an asbestos crime-fraud controversy in the US (Hazards 123) - authored with Bernstein an April 2007 criticism of the International Agency for Research on Cancer (IARC).

The article accused the UN agency of “misconceptions and misuse” of cancer classifications. The paper, in the journal Indoor and Built Environment, defended the continued use of chrysotile.(8) It noted: “Unfortunately, eliminating substances on the grounds of inherent hazard can deny major benefits to societies and undermine the sustainable developments. This is nowhere better illustrated than in the case of the minerals known collectively as asbestos.”

The article so impressed the Russian chrysotile industry, it has pride of place on its website.

Hoskins and Gibbs were also co-authors with Bernstein of an International Chrysotile Association (ICA) defence of chrysotile. It was a major undertaking, with Bernstein charging by the hour and billing for over $200,000 from ICA. Another author, Jacques Dunnigan, also received a substantial sum. Gibbs states he received no payment for the work – his normal hourly rate for work for defendants in compensation cases is US$600 – reporting he only spent a few hours reviewing the paper. The financial arrangements we know about only became public when the authors were deposed in court regarding their chrysotile-related work for defendants.

The product of this ICA investment was Health hazards of chrysotile revisited, a 2013 paper in the journal Critical Reviews in Toxicology.(9) The paper was immediately criticised for providing misleading information about its funding and about its content. It claimed to be funded by a ‘grant’ from International Chrysotile Association (ICA), when in fact court depositions show the ICA money went to individual consultants on its payroll, at an hourly rate.

It also claimed to be a 'study' when it was a review, and a distinctly skewed one at that. As the Rideau Institute’s Kathleen Ruff noted, it “omitted critical literature that contradicts the pro-asbestos message they always promote.” This included a 2012 International Agency for Research on Cancer (IARC) review that confirmed: “There is sufficient evidence in humans for the carcinogenicity of all forms of asbestos (chrysotile, crocidolite, amosite, tremolite, actinolite, and anthophyllite)”.

While the industry-financed chrysotile revisited paper accepted “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.”

To those familiar with the work of Bernstein and his collaborators, the finding was not unexpected. A 2006 paper in the journal Regulatory Toxicology and Pharmacology,(10) this time authored by just Bernstein and Hoskins and produced with funding from the Chrysotile Institute’s precursor, the Asbestos Institute, 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 in its entirety on the website of the Chrysotile Institute.

Helping chrysotile survive

These are not papers that exist in a vacuum. Many are produced with the support of the industry, to be presented in defence of occupational cancer claims. Others are used to frustrate efforts to better regulate the use of chrysotile.

And the strategy works. Ford’s investment in asbestos studies has turned an accepted link between exposure to dust from asbestos brake linings and cancer an issue where there is just enough doubt courts might take the company’s side.

And when the International Chrysotile Association (ICA) commissioned Bernstein and co-authors including Hoskins and Gibbs to “revisit” the chrysotile evidence, it did it with an express purpose. Bernstein, for example, invoiced ICA for in excess of US$6,000 for: “Preparation of CD of the pdfs of the references included in Chrysotile Heath Risk Revisited for the Rotterdam Convention and for distribution by ICA.” The publication was a highly visible resource in 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.

And in February 2013, the article was the key reference in an ICA bid to reverse a decision the Pakistan National Assembly’s Standing Committee on Human Resource Development to recommend a complete ban on the import and use of asbestos. Pakistan continues to use chrysotile.

The industry’s campaign in Pakistan was heavily criticised in a letter from 143 scientists and organisations from 30 countries published in the Archives of Environmental and Occupational Health in May 2013.(11) This noted that the “overwhelming” scientific evidence ICA claimed “supported the safe and responsible use of chrysotile” in fact “shows that chrysotile asbestos causes deadly diseases and that ‘safe use’ of chrysotile asbestos has not ever been documented.”

But with deep pockets and access to the world’s top public relations experts, the chrysotile lobby continues to get its ‘safe use’ message heard from Hyderabad, to Hanoi to Harare.

In Britain, where it all started, the industry still has its champions and they turn to chrysotile’s usual suspects to support their defence of chrysotile. “Only in the past few years have a series of new studies by some of the world's leading independent scientific experts on asbestos (such as Dr David Bernstein, Professor Fred Pooley and Dr John Hoskins) finally confirmed in exhaustive detail just how insignificant is the danger which chrysotile poses to human health,” the Telegraph’s Christopher Booker wrote in 2007.

“But by now, thanks to that basic linguistic confusion, the damage has been done - making 'asbestos' arguably the single most expensive word in history.”

Scary stuff

Booker, a serial sceptic, was promoting his new book, ‘Scared To death: From BSE to global warming, how scares are costing us the Earth.’ In a chapter dedicated to asbestos, he singles out for praise Bernstein, Hoskins and Pooley, citing references from their chrysotile industry-financed back catalogue, and describing the 2007 attack on IARC co-authored by the Brits Pooley, Gibbs, Hoskins and Donaldson as “magisterial”.

The paper, Booker notes, “emphasised the damage that any further bans on white [chrysotile] asbestos could do to the developing world, where ‘cement products such as water pipes and boards for housing’ have proved invaluable. If these are no longer available, this would ‘cost rather than save lives.’”

It has been a recurring theme for Booker. Back in 2004, in his Telegraph ‘notebook’ column he cited separately articles by Bernstein, Pooley and Hoskins as “a series of new studies by internationally-respected scientists” that “exposed a scientific blunder that threatens to cost tens of billions of pounds, and which could affect millions of businesses and homeowners.”

Booker reiterated that this “blunder” was a failure by “Brussels and the Health and Safety Executive” to distinguish “between the genuinely dangerous amphibole forms of asbestos and white asbestos or chrysotile, a wholly different mineral chemically indistinguishable from talcum powder.”

In a 28 May 2008 column, again in the Telegraph, he wrote: “At a seminar last month, shocked NFU members heard a presentation from Dr John Hoskins, a leading asbestos toxicologist, showing how the risks of white asbestos cement had been exaggerated by the HSE to promote the contractors' interests. His case was supported by a paper from another world expert, Prof Fred Pooley, of Cardiff University.”

In 2011, Guardian columnist George Monbiot noted: “Booker has now written 42 articles downplaying the risks of white asbestos,” repeating what Monbiot characterised as the same “false claims.”

None of these scientists can be held responsible for anything Christopher Booker writes. But they should be held accountable for their own erroneous statements and failure to reveal their industry ties when defending its product.

Supporting those selling chrysotile asbestos in the developing world isn’t a crime. Neither is producing industry-sponsored research to order. Nor is authoring papers that defy the ‘overwhelming’ scientific opinion on a carcinogen like chrysotile. But neglecting to mention those industry affiliations is a big deal. So is producing science that omits inconvenient evidence and that crosses over from plain scientific fact into clear product defence.

Maybe, just maybe, in the face of what is already the largest industry-created health catastrophe in history, there’s a reason to wonder if this combination of commissions and omissions really does cross the line.

Chrysotile – whiter than white?

 

Why is asbestos still in use? Because someone is selling it. High profile events orchestrated by the International Chrysotile Association (ICA) in Asia, Africa and Latin America set out to convince government ministers, regulators and the media their product is safe as houses.

Most wealthy nations have either banned all forms of asbestos or choose not to use it. But there is still a market out there, and some of the chrysotile industry’s most supportive scientists have a well remunerated sideline on the global asbestos promotional circuit.

High profile events orchestrated by the International Chrysotile Association (ICA) in Asia, Africa and Latin America pitch the wonders of chrysotile as an essential, cheap and healthy building material. The events target regulators, ministers and local officials, and have had remarkable success in blocking tighter regulation and bans and promoting continued use of asbestos products.

On 18 November 2015, the asbestos promotional circus descended on Vietnam, where John Hoskins, billed in the programme as an independent toxicologist and from the Royal Society of Chemistry, addressed a conference featuring top government officials and the national media. He told the Hanoi event that while high exposures in the past could cause the lung scarring disease asbestosis and lung cancer and mesothelioma, these were not a concern in today’s workplaces. “In fact exposures generally in any industry are now so low these diseases are now purely historical, we should not expect to see them again.”

He reiterated: “The important thing to remember is these diseases only occur following high exposure, with the possible exception of mesothelioma caused by exposure to what I call amphibole asbestos types, which does not concern us here, as they are not used in Vietnam at all.” Hoskins added that “lung cancer is mostly caused by amphibole asbestos and the fairly general rule is that mesothelioma is caused by exposure only to amphibole materials.”

Pointing to a study in 2000 authored by Darnton and Hodgson(12) of the UK Health and Safety Executive (HSE) as proof of the greater danger posed by amphibole asbestos compared to chrysotile, he admitted it was “unfortunately not based on totally accurate data, which would be modified today, but nevertheless showed amphibole as asbestos is far more potent than chrysotile.”

What Hoskins didn’t tell the Hanoi audience was that the paper in fact under-estimated the relative risks of mesothelioma posed by chrysotile asbestos, with the authors themselves admitting in 2009 it “is higher by a factor of 10” than they had originally calculated.(13) Instead, Hoskins said: “All the studies seem to suggest that chrysotile does not cause mesothelioma.”

He said the reason the issue was contentious was because “there are people who wish that the world didn’t use chrysotile. They do it largely for their own devices, because they are lawyers or people who will benefit in some way from the confusion.” Hoskins told the conference that the “World Health Organisation has never said chrysotile should be considered too dangerous to use.”

But colluding with those wanting to seen an end to all asbestos trade were “people employed by the World Health Organisation”, he said, “who it seems fairly obvious in their presentations have their own agenda, and have said we have to look at the number of people who have asbestos diseases.” He said this was wrong because “in modern workplaces” exposures high enough to cause asbestos diseases “don’t occur” and because of this asbestos-related diseases “would die out in 50 years”.

Continuing his criticism of these unidentified WHO employees, he said: “They confuse amphibole with chrysotile asbestos, they ignore discussions about the level of exposure and they ignore modern factory practices. To back up their story they are very selective in the quotes they use.”

Hoskins was dissembling. It is inconceivable he was unaware of a 2006 WHO statement, ‘Elimination of asbestos-related diseases’.(14) The document noted that “all types of asbestos cause cancer in humans.” It added given “the increased cancer risks have been observed in populations exposed to very low levels, the most efficient way to eliminate asbestos-related diseases is to stop using all types of asbestos.” This came top of a list of WHO commitments “to work with countries towards the elimination of asbestos-related diseases”.

In 2007, WHO and the UN’s International Labour Organisation (ILO) agreed an Outline for the development of national programmes for the elimination of asbestos-related diseases, reiterating the importance of stopping use of all forms of asbestos.(15) The blueprint noted “all types of asbestos are known human carcinogens and no threshold has been identified for the carcinogenic risk of chrysotile asbestos that accounts for 95 per cent of all uses of asbestos today.”

While critical of others motives, Hoskins has been neither forthright nor forthcoming about his own possible conflicts of interest. He has failed repeatedly to declare in scientific papers his ties to the chrysotile industry, a major ethical breach in academia. Some of his co-authors of the Health hazards of chrysotile revisited paper commissioned by the International Chrysotile Association declared their prior work for asbestos interests. Hoskins did not. In the pre-erratum version of the 2015 Epidemiology, Biostatistics and Public Health paper, Hoskins again failed to mention his work for the asbestos lobby. And even the erratum did not include a reference to his work for ICA.

The Vietnam meeting wasn't Hoskins first outing on the asbestos promotional circuit. He was for example at a speaker at a major ICA event held in New Delhi, India, in December 2013
.



 

References

1 Edward B Ilgren, Frederick D Pooley, Yumi M Kumiya, John A Hoskins, Critical reappraisal of Balangero chrysotile and mesothelioma risk, Epidemiology, Biostatistics and Public Health, volume 12, number 1, 2015.

2 Stefania Boccia and Carlo La Vecchia, Erratum, Epidemiology, Biostatistics and Public Health, volume 12, number 3, 2015.

3 Corrado Magnani, Dario Mirabelli, Francesco Barone-Adesi, Roberto Calisti, Roberto Compagnoni, Bice Fubini, Stefano Silvestri, Benedetto Terracini. Letter to the editor, Epidemiology, Biostatistics and Public Health, volume 12, number 3, 2015.

4 Stefania Boccia and Carlo La Vecchia, Erratum, Epidemiology, Biostatistics and Public Health, volume 12, number 4, 2015.

5 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.

6 Jock McCulloch and Geoffrey Tweedale. Defending the indefensible the global asbestos industry and its fight for survival, Oxford University Press, ISBN: 9780199534852, 2008.

7 David Michaels. Doubt is their product: How industry's assault on science threatens your health, Oxford University Press, ISBN: 9780195300673, 2008.

8 David Bernstein, Allen Gibbs, Fred Pooley, Arthur Langer, Ken Donaldson, John Hoskins, Jacques Dunnigan. Misconceptions and Misuse of International Agency for Research on Cancer ‘Classification of Carcinogenic Substances', Indoor and Built Environment, volume 16, number 2, pages 94-98, April 2007.

9 David Bernstein, Jacques Dunnigan, Thomas Hesterberg, Robert Brown, Juan Antonio Legaspi Velasco, Raúl Barrera, John Hoskins, Allen Gibb. Health hazards of chrysotile revisited, Critical Reviews in Toxicology, volume 43, number 2, pages 154-183, 2013.

10 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.

11 Statement in response to asbestos industry efforts to prevent a ban on asbestos in Pakistan: chrysotile asbestos use is not safe and must be banned. Archives of Environmental and Occupational Health, volume 68, number 4, pages 243-9, 2013.

12 JT Hodgson and A Darnton. The quantitative risks of mesothelioma and lung cancer in relation to asbestos exposure. Annals of Occupational Hygiene, volume 44, ages 565–601, 2000. 

13 JT Hodgson and A Darnton.  Mesothelioma risk from chrysotile, Occupational and Environmental Medicine, volume 67, number 6, page 432, 2009.

14 Elimination of asbestos-related diseases, World Health Organisation, 2006.

15 Outline for the development of national programmes for the elimination of asbestos-related diseases, International Labour Organisation/World Health Organisation, 2007.

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Britain has history on asbestos. It has the highest death rates from asbestos cancers in the world. It is also home to some of the industry’s most relied-upon scientists. Hazards editor Rory O’Neill investigates.

Contents
•  Introduction
•  Eminently wrong
•  At home with asbestos
•  Product defence
•  Helping chrysotile survive
•  Scary stuff
•  Chrysotile – whiter than white?
•  References

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