The just released position paper by the Joint Policy Committee of the Societies of Epidemiology (JPC-SE) (see related article this issue) was created through a several month process beginning in 2011 which involved numerous hours of meetings and hundreds of emails and which may be unprecedented for the degree of collaboration exhibited by the 13 participating organizations. Led by chairman Stanley H. Weiss of the University of Medicine and Dentistry of New Jersey - New Jersey Medical School, it appears that no stone was left unturned in seeking to verify and cross check all the reference sources used, address and respond to all the objections, and to conduct the process in the most transparent fashion possible.

According to Weiss, the position statement approved by the Committee in June 2012 is actually the third version of a position statement which was initially completed earlier this year and further revised to incorporate additional details in response to comments. Weiss took his Committee back to the drawing board for two more rounds even after the statement was approved earlier this year before asking the Committee to declare the current statement “truly” final.

Evolution

The first statement was short and sought to make policy recommendations and assumed that the science around asbestos was not contested. When some objections to the science were raised, the Committee undertook a thorough review, including innumerable publications and a critical examination of  the relevant science. The final Position Statement has been reviewed very favorably by asbestos experts not involved with preparation of the Statement and is the most thorough version, according to Weiss.  Given its extended length, an Executive Summary was added.

Quality Review

Some of the data in the statement are so up to date that they have not been published yet and are referenced as “personal communication” in the Position Statement. The final Statement was reviewed sentence by sentence in an effort to assure accuracy. Many of the references the Committee uncovered were not easily accessible to non-scientists, so the Committee has taken extra pains to make most of its sources easily available as clickable links in the Statement to enhance public access by all.

Lessons Learned

In discussing the process with the Epi Monitor, Weiss highlighted several important observations and/or lessons learned that may be relevant to future efforts by the Committee to speak out on key policy issues in epidemiology and public health. Among the observations or lessons were:

1) Epidemiology societies have different experiences and have something to learn from each other as a result of these differences. One easy to understand example of this is the different experiences which can be shared by epidemiologists in societies from other countries because some will have already addressed policy challenges which others are confronting for the first time.

2) The role of epidemiology societies in responding to public health problems is not fixed. Some of the epidemiology societies entered the overall organization or the preparation of the asbestos statement with a view that it is not advisable for epidemiologists to take a stand on policy matters. According to Weiss, that view evolved during the Committee deliberations such that some who were initially opposed to taking a stand came to believe it was not right to  sit back and not speak out.

3) Epidemiology societies need to have conflict of interest disclosure rules and recusal rules for epidemiologists or others who may be serving as officers of the associations. Not all of the collaborating societies had such rules when the Committee’s work began.

4) The lessons learned from understanding the earlier efforts of tobacco companies to block public health actions were helpful in understanding the efforts of the asbestos companies today. Weiss told the Monitor he became convinced of this after making a special point to read books about tobacco company efforts.

Earlier Vision

Weiss credited Michigan’s Betsy Foxman for some of the learning which took place in the various societies during the process, noting that this was one of her long-term hopes in organizing the first multi-society (North American) Congress of Epidemiology. The current joint policy committee is an offshoot of the second of those Congress meetings, held in 2006.

Advocacy Clarified

Weiss was careful to make a distinction between the active advocacy such as may be practiced by groups such as the Sierra Club and the policy involvement undertaken by the epidemiology societies in relation to asbestos. Epidemiologists came to better understand, said Weiss, that even when there may be a consensus about the facts, it does not necessarily move policy makers or decision makers as expected. To the contrary, obstacles can be created by interested parties, and epidemiologists need to understand how to deal with them, said Weiss.