Chrysotile In India: Truth Held Hostage Indian Journal Of Community Medicine Vol. 31, No. 1Published by MAC on 2005-01-15
Source: Indian Journal of Community Medicine ()
Chrysotile in India: Truth Held Hostage
S. Chaturvedi, Editorial, Indian Journal of Community Medicine
Vol. 31, No. 1 (2006-01 - 2006-03)
Information showing asbestos-cancer relationship was available as early as the 1940's. During next 2 decades, enough epidemiological as well as experimental evidence was generated to prove this relationship. For half a century the asbestos industry, in collaboration with some of the leaders of occupational and respiratory medicine, was able to suppress most of the data1. Meanwhile, millions of people were exposed to the carcinogen and hundreds of thousand died. The knowledge that asbestos causes cancer became public in the 80's, not because of scientific community but as a result of prolonged struggle and legal actions by ordinary people. For decades, certain privileged sections of the world order, including some scientists, were instrumental in the enormous release of a known carcinogen, just to keep their 'profits' intact. Now we have a job on our hands - for a century - to combat the insult. Isn't it a profound statement on our times, our polity and to an extent our science?
This is just a punctuation in the whole story that ceases to conclude. It has worrisome sequelae, especially for the developing countries. Burden of industrial pollutants reach this part of the world much faster than the fruits of industrial growth. Bias of global power structure against us is there for all to see. However, certain crippling local factors contribute to our suffering in equal measure. Weak politics, weak science and weak legislation - further impaired by spurious enforcement - is no match to a strong and defiant corporate, augmented by opportunistic use of mass media. Projections suggest that asbestos cancer epidemic may take more than 10 million lives before the exposures are brought to an end by banning asbestos globally2.
Asbestos is the generic term given to a group of fibrous minerals found throughout the upper crust of Earth. Chrysotile, amosite, crocidolite and anthophyllite are four commercially important forms. Chrysotile (white asbestos) alone accounts for 95% of global asbestos production. Most of it comes from Quebec, Canada3. The largest user of chrysotile fiber (85% of total use) is asbestos cement industry4. Today we have incontrovertible evidence that besides causing a progressive fibrotic disease of lung called asbestosis, asbestos (including chrysotile) also causes cancer of lung, malignant mesothelioma of pleura and peritoneum, cancer of larynx and some gastrointestinal cancers5-8. In late eighties and nineties, scientific community responded with earnestness and clarity. The impact was positive and immediate. Environmental Protection Agency (EPA)3 and WHO's International Agency for Research on Cancer (IARC)9 declared asbestos a proven human carcinogen. When some doubts were raised that white asbestos may be having lower level of carcinogenicity than other forms, the issue was carefully re-examined. Some studied inferences have been drawn after careful deliberations: chrysotile, like all other forms, is a potent human carcinogen; no threshold has been identified for carcinogenic risks; asbestos exposure and smoking have synergistic effect on risk of lung cancer; and chrysotile should be replaced by safer substitutes, wherever available9-12.
Over 40 countries have banned all forms of asbestos, including chrysotile. From January 2005, no asbestos product would be released in all 25 member states of European Union. In contrast, the Indian asbestos companies continue to flourish in pro-asbestos climate. Since new asbestos use in being made increasingly difficult in developed world, the global asbestos corporate is trying to create new markets in the countries with weak legislation. Rapid growth potentials are being used as a ploy to stall the process of asbestos-ban. The results are visible, with an annual growth of 9% in asbestos-cement sector in India. Market stakeholders have a strong incentive. They are influencing policy to ensure a constant reduction in asbestos custom duties. One of India's biggest asbestos-cement companies, reported a net income of over 10 million US$ for 3rd quarter of 2004, an increase of 25% on the preceding quarter. Its new production unit in Karnataka should be operational by now. Rising revenue and increasing manufacturing capacity of all major asbestos players make asbestos a 'good investment' in share market according to financial analysts and advisors14.
Vast majority of the asbestos produce (80%) is used for rural low-cost housing, schools and industrial structures. Recently, efforts were made to use asbestos products in the rehabilitation work for the tsunami victims, even when safer, non-inflammable substitutes existed.
To dominate the Indian asbestos agenda, a corporate sponsored misinformation campaign has taken aggressive mode in public domain. India has seen a media blitzkrieg of pro-asbestos propaganda in 2003-2004. Initially is started with full page advertisements15,16 in most of the national dailies and magazines, appearing on regular basis. Then came the spate of speical supplements, full page features and news stories. They were apparently authored by the asbestos cement manufacturers but the credit line was either anonymous or belonged to the newspaper, providing much needed reach and credibility to the industry17. Many of these features have misreported scientific papers and proceedings18.
Web-based electronic news papers are following such stories. Counterpoints and protests are either ignored or marginalized to small letters. This cynical abuse of money and power under the garb of freedom of expression continued in 200519. We can't expect a dramatic change in the character of big media. It is not simply a matter of funding. In fact, the corporate owns most of the channels of mass communication by proxy. Financers have acquired a direct control over editorial policies and space for independent opinion has been pushed to margins.
In this climate, there are no level playing fields and asbestos industry is likely to enjoy a huge clandestine support by 'hidden persuaders'. However, this can be effectively neutralized by peoples' awareness and concerted perseverance of scientific associations. A scientific debate that relates to people's health is being played out in public, without any visible opposition. The only way out seems to be academics' direct partnership with people. It would be fatalistic to say that that academics don't stand a chance against media onslaught. Even a single vote matters and can start a critical motion for huge changes.
Coming back to Lilienfeld's historial work1, it must be noted with concern that such type of science-corporate nexus is not limited to asbestos alone. A similar history has been documented in the dye industry as well20. Response of civil society - including the state - has been suboptimal to prevent recurrences. We continue to live with the risk of similar public health disasters, more so in the developing world. Wherever funding agencies are allowed to set the agenda in science, truth is likely to be held hostage. To quote Lilienfeld: "The degree to which scientific fraud permeated published reports is also of concern. The activities described suggest that that fraud in non-governmentally supported research occurs, and that it has potentially great impact on health policy.
However, unemployment or withdrawal of research support may be the ultimate 'reward' for those who do not participate in such activities. The implementation of mechanisms to prevent such fraud should not await yet another public health tragedy."
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20)University College of Medical Sciences and GTB Hospital, Delhi.