Re: Doll's 1955 study on cancer from asbestos.
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Biomedical subjects
Publications and source records attributed to B I Castleman.
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International scientific organizations have been subject to repeated efforts by Canadian government officials and representatives of the asbestos industry to issue reports that would be favorable to the industry on questions of asbestos use and public health implications. In recent years these efforts have been met with international opposition from scientists, governments, unions, and environmental groups, and a pattern of improprieties, often involving the same individuals and tactics, has emerged. This has been a serious threat to scientific objectivity at the most respected international scientific bodies in the world. The manipulation of these international organizations takes on unprecedented significance in this age of the World Trade Organization.
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A 1989 Occupational Safety and Health Administration standard mandates that workplace air concentrations be held below new permissible exposure limits for 376 substances. As more than 350 of these limits came from the 1987 list of "Threshold Limit Values" (TLVs), the medical basis of the TLVs is of direct importance to the health of millions of workers. However, the TLV development process has been gravely flawed by lack of scientific rigor, inadequate medical input, and lack of attention to financial conflicts of interest. The adoption by the Occupational Safety and Health Administration of many poorly supported values as permissible exposure limits reflects also the underutilization of industrial medicine in identifying health effects of exposures below the TLVs. It is thus the responsibility of the medical profession to act on the presumption that the TLV permissible exposure limits are unsafe limits until a sound underlying body of medical and scientific literature exists for the substances on the list. It is industry's responsibility to commit itself seriously to medical and exposure monitoring and to begin to remedy the knowledge deficit that exists about the less immediate health effects of most industrial materials.
Investigations into the historical development of specific Threshold Limit Values (TLVs) for many substances have revealed serious shortcomings in the process followed by the American Conference of Governmental Industrial Hygienists. Unpublished corporate communications were important in developing TLVs for 104 substances; for 15 of these, the TLV documentation was based solely on such information. Efforts to obtain written copies of this unpublished material were mostly unsuccessful. Case studies on the TLV Committee's handling of lead and seven carcinogens illustrate various aspects of corporate influence and interaction with the committee. Corporate representatives listed officially as "consultants" since 1970 were given primary responsibility for developing TLVs on proprietary chemicals of the companies that employed them (Dow, DuPont). It is concluded that an ongoing international effort is needed to develop scientifically based guidelines to replace the TLVs in a climate of openness and without manipulation by vested interests.
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The export of hazards to developing countries, frequently associated with the transfer of technology, is an increasing public health problem. It may arise from the export of hazardous products and wastes, or from the transfer of hazardous industries in the absence of appropriate safeguards. Multinational corporations bear a major responsibility for having lower standards of health protection in manufacturing and marketing in the developing countries than in home-country operations. These firms are coming under growing international pressure from concerned citizens, unions, environmental groups, national governments and international organizations, religious groups, the media, and public health professionals.
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The international asbestos industry is under considerable pressure in some countries to control dust exposures in the workplace and restrict pollution. In addition, major firms in the United States face mounting compensation costs for past failures to protect asbestos workers. At the same time, however, the asbestos industry is expanding in developing nations, largely on the strength of sales of asbestos-cement construction materials. This report describes problems encountered with the use of asbestos-cement in schools and low-income housing in Puerto Rico, resulting in the condemnation of these buildings and the relocation of over 1,000 families at public expense. The manufacturer of the asbestos-cement panels, a Colombian affiliate of the European-based multinational Eternit, escaped all liability. The issue is presented as a needless, expanding threat to public health worldwide. Safe, economic alternatives exist, such as the use in some cases of crop waste fibers in place of asbestos as a cement binder. There have also been major advances in the commercialization of asbestos-free brake and clutch friction products.
The export of hazardous industrial plants to developing nations is examined for a number of industries. As hazardous and polluting industries come under increasing regulation in industrial nations, some of the affected processes are exported, without improvements to make them less hazardous, to nonregulating countries where cheap and uninformed labor is abundant. "Runaway shops" then market their products in industrial nations with the competitive advantage of not having had to comply with costly workplace and pollution-control regulations. The international trade impacts of hazard export include: export of jobs from regulating to nonregulating countries; shift of international balance of payments in favor of nonregulating countries; export of mortal health hazards and environmental destruction to workers and communities in nonregulating nations, in order to produce goods for consumption by the regulating countries; weakened competitive position of reputable manufacturers who incur control costs and complete in domestic and would markets against less scrupulous companies; prolonged widespread use of discredited, extremely hazardous technologies, arising from the continuing "subsidy" of certain industries by workers and communities exposed to uncontrolled, well-recognized, mortal health hazards; and aggravated international relations resulting from developing nations' awareness and concern over becoming dumping grounds for hazard export from industrial nations.
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