Corruption of the medical literature: a second visit

Our plain-English summary of Corruption of the medical literature: a second visit, by D.S. Egilman, C.M. Hom (American Journal of Industrial Medicine, 1998).

The study

• Authors: D.S. Egilman, C.M. Hom
• Journal: American Journal of Industrial Medicine
• Published: 1998;34(4):401-4; discussion 409-10
• Type of article: Historical article
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This is a commentary, not a research study. The authors responded to a 1997 article by Borron et al. that reconstructed the 1931–1932 Metropolitan Life/Johns Manville study of asbestosis among manufacturing workers, conducted by Dr. Anthony Lanza. The authors argued that Borron et al. left out a finding of the Lanza study: asbestosis in a watchman, a pipe fitter and five shipping department workers. Drawing on unpublished insurer and company documents, the authors argued that Lanza publicly denied an asbestos hazard in mining while knowing of a 1930 X-ray survey in Quebec. That survey reported that 24 of 54 men examined at Thetford Mines had asbestosis, a rate the authors gave as 44%, and Metropolitan Life had not given permission to publish it. The authors quoted a 1933 memo in which Lanza advised a Johns-Manville plant physician against asbestos warning posters, citing "the extraordinary legal situation." In the same memo, Lanza suggested that a worker with asbestosis who was well along in years and showed no disability might be left alone rather than moved out of an extremely dusty job. The authors concluded that corporations and the scientists who work for them too often put corporate economic interests ahead of workers, consumers and the public, and that Lanza was one such man.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Commentary (critical response to another published article), based on historical documents and correspondence
• Who was studied: No study population. The commentary discusses Dr. A.J. Lanza and documents on the 1931–1932 Metropolitan Life/Johns Manville study and a 1930 X-ray survey of asbestos miners at Thetford Mines and Asbestos, Quebec. It also discusses a 1933 memo about the Johns-Manville plant in Waukegan, Illinois.
• Exposure: Asbestos dust in mining, milling and manufacturing work. This includes bystander jobs exposed through what the authors call fiber drift, and the card room of a textile department. Fiber type is not specified, apart from a reference to a "Canadian Chrysatile defense" (spelled this way in the article).
• Main results:
  • The authors argued that Borron et al. omitted that the Lanza study found asbestosis in bystander workers: a watchman, a pipe fitter and five shipping department workers.
  • The authors quoted an unpublished 1930 report: of 54 men examined at Thetford Mines, 24 were diagnosed by X-ray with pneumoconiosis (asbestosis). The authors described this as a rate of 44% and said Metropolitan Life suppressed publication.
  • The authors quoted a 1932 letter from McGill Clinic director Pedley. It said the results of the 1930 survey of some 150 men had been reported to Lanza, but permission to publish had not been secured.
  • The authors cited a 1944 Metropolitan Life report by Wheatley. It said 1 active case of tuberculosis and 42 cases of asbestosis had been found among the 195 individuals in Pedley's 1930 survey.
  • The authors quoted a 1933 statement by Lanza denying a dust or asbestos hazard in mining or quarrying operations, despite the 1930 survey.
  • The authors quoted a 1933 memo in which Lanza advised against warning posters about asbestos dust, citing the legal situation.
  • In the same memo, a plant physician proposed moving a worker with asbestosis out of an extremely dusty card room. Lanza replied that an older worker with no disability might be left alone, and that economic and production factors must be balanced against medical factors.
  • The authors quoted a 1934 letter to Lanza asking that his finding that asbestosis appeared milder than silicosis be kept in his report because it was favorable to the industry.
• The authors' conclusion: The authors concluded that the lesson of Lanza is not lack of scientific consensus or wartime priorities. In their view, corporations and the scientists who work for them too often place corporate economic interests ahead of workers, consumers and the public, and Lanza was one such man.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis.

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