Reimagining Our System for Public Health Protection

Our plain-English summary of Reimagining Our System for Public Health Protection, by D. Michaels (American Journal of Public Health, 2019).

The study

• Author: D. Michaels
• Journal: American Journal of Public Health
• Published: 2019;109(7):975-976
• Type of article: Comment
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

In plain English

This is an editorial, an opinion article, not a research study. The author argued that the US system through which government agencies protect public health, safety and the environment was being severely challenged and needed to be rebuilt and reimagined. As an example of past failure, the author described a case documented by Rosner et al. in the same issue. The Food and Drug Administration (FDA) proposed requiring that talc products be virtually asbestos-free, then retreated. It let industry develop its own less stringent methods for detecting asbestos. By 1977, the author wrote, the FDA had essentially accepted the industry's assertions that its talc products were safe. The author suggested underfunding, a weak cosmetics law and reluctance to fight a long legal battle as likely reasons. The author noted that the first study linking consumer talc use with ovarian cancer was published in 1982. The author called for more agency resources and evidence from unconflicted scientists. The author also argued that action on chemicals and other products reasonably predicted to be harmful should not always wait for proof of harm.

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: editorial (opinion piece), not a research study
• Who was studied: No study population. The editorial discusses US government agencies that protect public health, safety and the environment. It uses the FDA's handling of asbestos in consumer talc as an example.
• Exposure: Asbestos in consumer talcum powder products (no fiber type named)
• Main results:
  • Citing the case documented by Rosner et al., the author wrote that the FDA proposed requiring that talc products be virtually asbestos-free but then retreated.
  • According to the author, the FDA let the industry develop its own less stringent methods for detecting asbestos.
  • The author wrote that the industry changed the definition of cosmetic talc from asbestos-free to a product whose asbestos content was 'nondetected'. The author noted that whether asbestos can be detected depends on the methods used.
  • According to the author, by 1977 the FDA had essentially accepted the industry trade association's assertions that its talc products were safe.
  • The author suggested that one likely reason the FDA yielded was that its law authorizing regulation of cosmetics was and remains weak.
  • The author noted that the first study linking consumer talc use with ovarian cancer was published in 1982. That study was by other researchers and is cited as reference 2.
• The authors' conclusion: The author concluded that public health protections should be reimagined, with adequate resources and evidence from unconflicted scientists. The author argued that the presumption of innocence should not apply to chemicals and other products that might reasonably be predicted to be harmful. In the author's view, waiting for proof of harm before acting will too often permit harm to occur.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Talc and vermiculite.

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