“Scientists and academics have a role to play to speak up against this ongoing corruption of public health policy which causes unnecessary disease and deaths.” That’s how Kathleen Ruff, an activist and founder of Rights on Canada has characterized at a recent one day conference in Montreal some of the research carried out at McGill University and the internal investigation of this alleged corruption of policy by the University. The conference (Asbestos: Dialogue for the Future) was called by the Faculty of Medicine to engage in a baseline discussion about what asbestos is, how it has been used historically and its impact on human health, and to participate in a dialogue for the future with respect to research policy, ethics, and the broader context,” according to the University.

Allegations

In a presentation entitled “A Failure of Ethics by McGill University”, Ruff used her presentation to allege that the research carried out by Prof JC McDonald, a former head of the Department of Epidemiology and the use of that research improperly served the interests of the asbestos industry and undermined public health policy.  Among the allegations she makes are that there were improprieties in the research itself, that the research minimized the threat to health posed by chrysotile asbestos (calling it “essentially innocuous”), that there had been improper asbestos industry influence, and that McDonald had at times denied that the asbestos industry was funding the research.

Asbestos Problem

The presentation by Ruff is important because asbestos continues to be exported around the world and for the past 20 years asbestos sales have stayed at around 2 million tons per year despite overwhelming scientific evidence of the harm caused by asbestos. The asbestos industry says that chrysotile asbestos in virtually harmless and should continue to be used. The evidence on asbestos was the subject of a recent extensive review of the literature by a consortium of professional epidemiologic associations in 2012 which issued a statement that asbestos is harmful in all forms and should not be used.

Review

McGill carried out a review of the allegations and dismissed them. Ruff and others at the conference believe the process followed by McGill to investigate the allegations was biased, lacked independence, lacked transparency, and the report issued was inaccurate and contained misleading information. 

In concluding her paper, Ruff stated “a vast imbalance of power exists between the asbestos industry and people overseas to whom the industry continues to ship 2 million additional tons of asbestos every year. Ethics means protecting the right to health of the powerless. Consequently, it is critical that McGill’s broken ethical review system be repaired.

According to Ruff, McDonald’s research is still of concern because the asbestos industry continues to use his research to promote the sale of asbestos, and chrysotile asbestos represents 100% of the global trade.

McGill Response

 In correspondence between McGill’s David Eidelman, Dean of the Faculty of Medicine and Ruff, McGill has provided its ethical guidelines and the specific sections which deal with conflict of interest. According to the Dean, “…all professors in the university are expected to observe the highest ethical standards in their work.” In response to a question of whether or not it is unethical for a faculty member to falsely deny any connection to the industry funding his or her research, the Dean agreed that IF such a situation occurred, it would not be in compliance with McGill’s current regulations.

So What?

One can ask why it is important to get further clarity about the issues raised by Ruff. If the allegations were proven to be correct, this would serve to discredit the previous work she describes at McGill and could lessen the influence that work has in the global policy arena.

Asbestos related diseases are still a major issue. The WHO has estimated that worldwide 90,000 people die each year from mesothelioma, lung cancer and asbestosis. Although worldwide consumption of asbestos has decreased, consumption is increasing in many developing countries. The limited data available suggests that exposures may also be high in developing countries. Mesothelioma continues to increase in most European countries and in Japan, but has peaked in the U.S. and Sweden. Although the epidemic of asbestos related disease has or is expected to plateau in most of the developed world, little is known about the epidemic in developing countries. It is obvious that an increase in use by these countries will result in an increase in asbestos related diseases in the future

Looking Forward

Regardless of the outcome of the allegations made by Ruff, it seems clear that improvements are needed in the procedures and practices that govern the oversight of conflict of interest. In his correspondence with Ruff, McGill’s dean pointed out a suggestion from the McGill conference to implement post-approval compliance monitoring to help insure that investigators are actually following the guidance given by Institutional Review Boards, and doing a better job of raising awareness about ethics regulations among students and faculty. 

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