Response to Hessel

Our plain-English summary of Response to Hessel, by D. Egilman (American Journal of Industrial Medicine, 2017).

The study

• Author: D. Egilman
• Journal: American Journal of Industrial Medicine
• Published: 2017;60(10):915-920
• Type of article: Letter
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

In this letter, the author replied to Dr. Patrick Hessel's defence of Kelsh et al. (2007), a reanalysis of Australian mesothelioma registry data on vehicle mechanics, and to Hessel's question, "Where is the corruption?" The author argued that Kelsh et al.'s failure to report that defence lawyers commissioned the research to assist in asbestos brake litigation, combined with results-driven methods, constituted corruption. He drew on litigation documents: an Exponent, Inc. 2002 work plan titled "Support Tasks for Asbestos Litigation," invoices, deposition testimony, and a 2010 letter from Dr. Dennis Paustenbach to Ford. From these he described how lawyers for automobile companies hired Exponent in 2000 to generate publications. He said Exponent agreed to provide defence experts before doing any research, and that the lawyers could have blocked unfavourable results. He stated that the disclosures in Hessel et al., Goodman et al. and Kelsh et al. did not report this litigation context. He also criticised the Goodman et al. (2004) and Garabrant et al. (2016) meta-analyses, arguing that studies based on job titles misclassified brake exposure. He noted that the all-tier meta-relative risk of 0.67 (95% CI 0.53-0.84) implied an implausible protective effect, and that upper confidence limits were consistent with increased risk. He cited industrial hygiene measurements and a 1973 industry address acknowledging high exposures from brake work. He concluded that consulting companies had been established to manufacture doubt.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This is a letter to the editor, not a research study. The author responded to a letter by Dr. Hessel that had defended a 2007 paper by Kelsh and colleagues, which reanalyzed Australian mesothelioma registry data. Citing litigation documents, the author stated that in 2000 defense lawyers for automobile companies hired the consulting firm Exponent to produce publications for lawsuits over asbestos from brakes. The author also stated that Kelsh et al and related papers did not disclose the lawyers' control over the work. The author argued that Kelsh et al's methods biased results toward the null. The author also criticized a 2004 meta-analysis by Goodman and colleagues. That analysis reported a meta-relative risk for mesothelioma of 0.67 (95% CI 0.53 to 0.84) across all three study tiers and 0.92 (95% CI 0.55 to 1.56) for Tier I. The author argued that a protective result was implausible and pointed to misclassification, because the underlying studies did not identify brake-exposed workers. In the author's view, the undisclosed funding arrangement and results-driven methods constituted corruption. The author disclosed testifying in asbestos litigation for injured workers and their families and for manufacturers.

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: Letter to the editor and commentary (a response to another letter); not an original study
• Who was studied: No study population. The letter discusses published papers on mesothelioma in vehicle mechanics and brake workers, chiefly Kelsh et al (2007), a reanalysis of Australian registry data, together with related papers and litigation documents.
• Exposure: Occupational exposure to asbestos released from automobile brakes (brake work by mechanics)
• Main results:
  • The author stated that in 2000, defense lawyers for automobile companies hired Exponent, Inc to generate publications for use in brake asbestos litigation.
  • The author stated that the authors of these papers did not disclose the litigation context or the lawyers' control over the papers.
  • The author argued, citing an earlier paper with a co-author, that Kelsh et al's methods biased the results toward the null.
  • The author quoted the Goodman et al meta-analysis: the meta-relative risk for mesothelioma was 0.67 (95% CI 0.53 to 0.84) based on all three tiers of studies, and 0.92 (95% CI 0.55 to 1.56) for Tier I. The author argued that this protective result was implausible and reflected misclassification or other error.
  • The author argued that the studies underlying the meta-analyses did not include brake-work job titles in the exposed group, and called this misclassification the critical flaw.
  • The author argued that the upper confidence limits of all the Garabrant et al (2016) meta-analyses were above 1 and were consistent with increased risk.
  • The author's disclosure: the author testifies in asbestos litigation for injured workers and their families, and for asbestos product manufacturing companies.
• The authors' conclusion: In the author's view, Kelsh et al's failure to report that defense lawyers commissioned the research, combined with results-driven methods, constituted corruption.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Auto mechanics and brake work, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Mesothelioma, Deposition, Relative Risk, Industrial Hygiene.

Related studies

• Corporate corruption of science-Another asbestos example — D. Egilman, R. Monárrez (2017)
• Mortality rates among employees potentially exposed to chrysotile asbestos at two automotive parts factories — M.M. Finkelstein (1989)
• Globally asbestos-free automobiles — J. Rangé (1999)
• Re: Comments on Egilman's response to Hessel regarding the health hazards of brake dust and his reflections on corporate behavior — D. Paustenbach (2019)
• Thinking about Occupation-Response and Exposure-Response Relationships: Vehicle Mechanics, Chrysotile, and Mesothelioma — K. Teschke (2016)
• Science or public relations? The inside story of the Asbestosis Research Council, 1957-1990 — G. Tweedale (2000)

Browse more research in American Journal of Industrial Medicine, or return to medical research.