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tv   [untitled]  CSPAN  June 27, 2009 8:00am-8:30am EDT

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me. if there are i'll fire the whole state department. >> more from the newly released tapes this afternoon on c-span radio. ..
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>> i would like to tell this as a story i will talk about the book and the story it tells and how it is laid out his starkly and give you one of the more appalling or terrible examples in the book then i will talk a little bit about the lessons from it. the place to start his tobacco it really did start their and that is for the title of the
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book comes from. there is a tobacco executive who otherwise they had the phrase doubt is our product is a means of establishing controversy. how to get to this point*? 1950's -- 1950, five studies are published thinking it cancer and cigarette smoking. this was early in epidemiology it may have been a shock to some people but the tobacco industry sought immediately they were facing problems. the founder of the world wide public-relations firm said you have a problem you have to address it in here is the strategy. hill had worked for the chemical industry before that and there is a congressional hearing on cancer-causing chemicals and food and he advised the chemical industry
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how to fend off propose legislation that would limit the chemicals in food. he was very successful. actually as the aside, the congressman that led the investigation was the lady from new york was able to get legislation passed was known as the delaney clause but for many years there's successful to push them back and hill was in charge. he said you need your own research to be be mercenary but you need opposing research to convince people that those other studies were not rob but they were not correct enough to reduce uncertainty and the tobacco industry successfully opposed the science for a long time all of the science which explains how the tobacco industry did that university of california's san francisco has millions of documents and they are wonderful to read.
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excuse me. how do i get to this? amount of things the tobacco industry did was published their own journals, newspapers, magazines a meeting of policymakers and scientists and physicians and they said focus on controversy, anything there raises a question about studies or what you should promote and dialing to them all to our website and it is worth reading because it is remarkable. there was extraordinary successful campaign for many, many years and hilt went on to market their expertise much more widely this is what is more well known of the '70s and '80s and '90s when different industries and
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corporations faced a crisis surrounding fermenta zero exposures, hill & nolten said we can help you. i was able to obtain documents i worked at the energy permit which was the primary user for release and but essentially hill & nolten described how they were successfully able to help not only the tobacco industry but how they helped other industries here is one on fluorocarbons or freon and ozone depletion many of the recall there was some science done in the '70s adjusting their modeling the release of fluorocarbons which were in as a propellant and aerosol cans was causing a hole in the ozone layer. additional studies confirm
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this and as hill & nolten explained in their own sales pitch, of the year about the future cost fluorocarbon users to look to an alternative. there we're asked by dupont to calm fears and gain to three years before the government took action. they did. that is exactly they were successful to put off action until dupont could come up with a replacement chemical and we had to three years of the ozone layer. the scientists said did that work received the nobel prize. it was not bad science but it was actually showing chlorofluorocarbons cause the problem. but the public-relations industry figure how they could sell this elsewhere but i believe scientists themselves saw this was a lucrative in denver, rather than let hill & nolten figure out how to do
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this but now we have a new industry they call themselves the product defense industry they understand how the regulatory system works out to produce studies that defense products and regulation or in court. they will produce literature reviews, there will occasionally do studies themselves but in my view it is quite simple. the studies they produce for clients are very much like the accounting work done by some of the accounting work from arthur andersen for enron. they appear to play by the rules but the objective is to help corporations, frustrate regulators in prevail in litigation. we see it over and over again in this case. will talk a little of that how this works.
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i tried to write about several groups but one works extensively for the tobacco industry for them in places where it felt it could not expose themselves saying it is these about good doing it pops from their marketing material asbestos, a tobacco, pharmaceuticals we are all next. let it is a good thing that it happened to tobacco amd asbestos but chemicals should have presumptive in this end that innocent until proven guilty and their the defense attorneys for the chemicals to make sure they're not found guilty. this is the example of one groups website until i started writing abroad in the "scientific american" and they pulled the case study but
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fortunately i kept the screen shot. those of you who follow the fda know that it essentially force is a drug off of the market for one of two reasons and i have to me pretty good reasons. one is that it does not work or the other if the show's the risk associated with the drug badly outweighed the benefits. obviously all drugs have risks but if the risk is great eventually will force off the market. does not happen much but it does this post 58 proposes cancellation of a new drug the one group says it is an extensive process with a written appeal leads to 10 additional years of sales whatever the drug was it did not work we had 10 additional years thanks to the average bigger. since writing this book talking about the practice
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they have changed their website they now call it product support. [laughter] i think it hurts all of us. gilbert understands this as well who he writes about having weasels to write articles casting doubt. we are being seen by the accountants at arthur andersen. one thing i began am deeply involved with teaching a course in a bar mental health policy at george washington, osha issued a proposed chromium standard which is a chemical commonly used in the workplace. it is extremely toxic comet 80 years ago factory workers had a trick they would take a dime and put up one nostril and
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pulled out the other because acute chromium exposure cause nasal perforations then it was under control and we stop seeing a but then discovered again in the fifties that it also greatly increased the lung cancer it is no debate. very powerful long carcinogen. ocean never got around to it up grading the workplace standard that was based on preventing holds in people's noses on the 1920 studies. and many, many people push for osha to get a new standard and finally they were sued by one of the union's in the research group and they lost in court several times. but it became clear in the 1990's to the chromium industry is some point* o chiao will strengthen the standards to protect the workers. the epa had decided to do a study of a factory in baltimore not to learn how to
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protect workers but because it is a public health problem across the board of they are exposed environmentally. so the 1990's is up period a challenge where they say we may actually have to start cleaning up our factories. what did they do? they hired the veterans of the tobacco, the same scientist cut their teeth questioning science and studies and they met with the chromium industry executives, i will tell you how i got these documents later and they came up with a strategy to critique the studies from me to sell the a major redoubt but literature we can see it with other sorts of critiques and literature searches and reducing the lung cancer problem is not real and we could get the raw data from the epa study to realize to
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make the results go away. we have the meeting in 1996 where they talked about doing that. of course, they decided, they said we will hire this company , but then they decided if the chromium industry hires them osha could possibly get a hold of their raw data and memos so they decide to use another trick they learned from tobacco, have the attorneys hire them because then all of the work is considered privileged through various legal structures. and all of that would be prevented from getting out to the public. we have all the contracts on the website. herman in the back was with the epa at the time and did a very good study of this plant in baltimore and found not
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surprisingly increase lung cancer risk of people exposed to chromium and in the regulatory interest of people were exposed at one micrograms per cubic meter they were exposed the old osha standard is 52 micrograms. so even at one microgram per cubic meter they were exposed would have increased risk of lung cancer. they tried to get a hold of the study is that the epa was doing but they could not do it. so what they did come of this was fascinating because they were trying to stop the lawsuit and force the issue they developed a stimulated population then conducted a study on them. on the basis of what we know, this is what we think the workers should look like and said there is no excess risk of lung cancer. eventually through the freedom of information act there were able to get the raw data and
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were able to do so more alchemy ed made the results go wait that workers were never exposed above the current 52-microgram label did not -- level did not faze excess rest. for july 1 of the judges said it is nonsense and forced pochette to issue a standard. this is the only health standard of the bush administration changes and they are forced to buy a judge. a very upstanding judge that required osha it proposed a standard of one microgram. so still at all levels that would be increased risk but far better than a level of 52. no one microgram there are still several and lung cancer deaths for every room thousand workers and osha said
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please, if anybody has any information of workers exposed at lower levels because they're all done on old factories. of course, industry use this to save the old studies are not relevant the new factories are cleaner you cannot go forward until you have studies of new factories. so osha bigger new data the national association of american manufacturers a great supporter of worker rights complained and said oh shut is that relating on 35 year profiles and italy reliance onto outdated studies and should continue to study the effects at lower levels. more study. more study. just as the comment period was closing i was asking my students about this because it was a great teaching opportunity i read the study in the "journal" of occupational medicine that the
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conclusion that the absence of the elevated lung cancer may be a favorable change an inquiry is the researchers have looked at the new factory cover the have not looked at people for very long or but it shows there is no real risk from low levels of exposure. the chromium chemical health committee from the industrial foundation. what is that? late one night i did some grupo and it just by luck because only on the web for a brief period of the industrial health foundation had gone bankrupt and there is a fight over chromium files and fortunately we were able to get the data from that and by cold calling the various creditors in the bankruptcy case, one holds role of information including and this
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was most remarkable a study done by the chromium industry of the low-level exposures an excellent study looking at four facilities and finding in fact, low levels of exposure their life was six micrograms per year. little higher than a level at issue was -- osha was talking about and people at higher levels, above six has twentyfold excess risk. this is a while finding but not surprising we know is a powerful carcinogen but here's an industry claiming you cannot move forward because you do not know the steady but they had the study and sat through 11 days of hearing with ocean never mentioning it existed. so the research group who was originally filing a petition with the bush assented been so they would put all of this
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information into the dock it and they said thank you very much did not affect their conclusions but then a second study came out paid for by the chromium industry a german cohort that includes a one cancer risk is elevated only in the high exposure group and we put them together what has happened was the industry had taken the old study which showed the very powerful effect of the regulatory interest close to the level osha would regulate they divided them of comet change the analysis published two studies which neither have showed anything. and here is the interesting thing instead of the intermediate group they merged into the low group and combined it. it is magic and all of a seventh day affect the locals goes away. and only by finding that trove of documents and reading the
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studies was i able to figure this out. this is what we see more and more of. we publish the us and of course, the moral is by the end osha pullback and instead of pushing for one microgram standard raised at five and gave the aircraft industry level of 25 so in practice of illustration can go on record of never issuing important health standards. one other thing you want to talk about is the interpretation of studies that is more insidious. i will make the case that scientists with financial conflict of interest cannot be trusted to provide a reasonable interpretation of data and i talk about all of this the book and on defending science the door. talking about vioxx, it was
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approved by the fda but you can see in the early days the first of these that were done lead themselves to conflicting interpretations but also another we would get eventually the truth was reached because in this case the first of these was comparing vioxx to leave because it was done as a pain killer. but later the study was done with vioxx to a placebo because they wanted to see a big prevented colon polyps. we have the placebo data after we compare it to leave. of the very beginning 2001, the "journal" of american medical association looked at the data and said look for it is pretty clear that patient was taking less
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has more than twice the risk of heart attacks as the one that is taking alleve. powerful findings. merck scientist paid by merck for that major medical centers replied, no. look at the studies to different ways either vioxx cars as a heart attack but we believe alleve is preventing heart attacks. we do not have a drug that prevents a 60% but we would put it in the water supply. [laughter] they say the defense is corteo protected and eventually the real truth came out with a placebo was done three years later hundreds of thousands of people, and millions of people took vioxx in the meantime. it was withdrawn from the market september 2004 but by then 20 million people had taken the drug and somewhere
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between 88,000 and 144,000 part attacks occurred because of this. this is a public health disaster. we see the same campaign and approach by the tobacco scientist much more widely. there is a famous memo from a political consultant who is a news analyst and focus group leader who wrote to the republican party in 2003 saying the global warming debate, the overview and the roach it is very clear the scientific debate remains open. lawyers believe there is no consensus about global warming. should the public come to believe that the side of the issues are settled, their view about global warming will change accordingly. there for you need to make the science and uncertainty. that was a few years ago but right now there is no credible scientists to would get up and
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say humans are not the cause of global warming and even president bush to acknowledge it is humans and now we are on david michaels 2.0 we see this same debate over the public health the fax the impact of global warming is there and the fact? we saw one of the doctors testifying in front of congress took six pages other for testimony exactly what is going on. they have moved the defense flyback but they will argue over the same point*. the they argue again and again my book is filled with examples the soft drink industry was battling the right to sell pop in school so they showed scoot soda from school vending machines does not contribute to the rise of obesity. it is out there. in the early days of
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cellphones, driving while using a cellphone would be banned the companies in telecommunications paid for a number of studies that showed driving while holding a cellphone is very little of no increase of injuries. we know that is nonsense but they produce the study's. in the early days they were part of the debate. the gasoline additive contaminated water supplies all across the country the state of california classified it as a possible carcinogen so the producers of that, call contacted a company and produced a study showing that it is not serious but then when tom delay tried to get legislation passed a taxpayers would pay for the cleanup so they said the cost is not high so they bought into it. you see that over and over. no matter how cynical you
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become it is never enough to keep up. we can do something about it. there is a very clear policy direction the first is called sarbanes-oxley for science. just as it help to clean up some of the outrages around the sec, we need transparency, full disclosure and publication of sponsor involvement and control of studies. the studies done under contract that says sponsors could publish and look at things before they're published we saw the article last week that philip morris controls publications from virginia university. but should be fully disclosed cannot allow. right now they're all sorts of rules regarding any study done by a federally funded researcher industry or anyone who wants to get the raw data but of the industry does the
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study that data can be secret and we should make sure scientist to have a finish to a conflict of interest cannot be on the federal and advisory committees otherwise we cannot trust their advice. the viet vioxx example is very clear. and very tragic side is with contract -- conflict of interest cannot see the truth in front of them. one thing i try to do is put all of these smoking guns on their website so they can download the documents and see what i am talking about. these are very powerful documents. i would love for you to do that. then i will take some questions [applause] >> so let's first asked from any journalists and anybody
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with a ph.d.? [laughter] so let's start here we will be bringing a microphone around a. >> figure for presentation you mentioned transparency and is closing conflict of interest. to be we will be using analysis and systematic review of the literature and comparative being used for drugs and devices but to be a key transparency of the criteria that you use to would make a particular study and i think of less people know that you cannot judge what is being analyzed. >> you are absolutely right.
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different sort of stock in drugs it turns out seven out of eight of those had a link to the drugs that have the statins. we cannot have that level of skepticism raised. in the vaults are held in future we can afford to hire scientists who have no connection so they can look at the field independently and


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