Doubt is Their Product: How Industry's Assault on Science Threatens Your Health Review

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Doubt is Their Product: How Industry's Assault on Science Threatens Your Health ReviewIf we believe David Michaels, industry charlatans all learned from the tobacco industry 50 years ago. The industries that rely on doubt have been blossoming ever since: beryllium (did you know that there was a beryllium industry? I did not), asbestos, and popcorn, among others.
Yes, popcorn. Were you aware that there is a condition called "popcorn lung" (officially bronchiolitis obliterans)? I was not. It's called that because one of the main ways to contract it is by working in a factory that manufactures one of the ingredients -- namely diacetyl -- for the butter flavoring in popcorn. Every time you open a steaming bag of butter-flavored microwave popcorn, you are inhaling a bit of this chemical. The more of it you eat, the more likely you are to contract a devastating lung ailment. (And this isn't the sort of disease that you'd only get by eating an implausibly large quantity of popcorn. Real popcorn consumers have actually acquired it.)
The agency responsible for protecting workers from this sort of hazard is OSHA. The one responsible for protecting food consumers is the FDA. This division of labor comes in for some well-deserved scorn in Doubt Is Their Product; it has left the government fairly impotent to respond to threats against the public health. This book could be read alongside Marion Nestle's Food Politics and What To Eat as a single thread about the assault on helpful government regulation.
In their nonstop fight against that sort of regulation, companies have pulled out all the stops to inject systematic doubt into the public discussion. The most pernicious of these, it seems to me, is the creation of sham peer-reviewed journals. Peer review is a negative process: if you can't pass peer review, your ideas are unlikely to have merit (though there are cases, says Michaels, where brilliant scientists -- future Nobelists -- have been denied peer approval). Passing peer review doesn't mean that your ideas are any good. Something similar applies to the references you give a potential employer: if you can't find anyone in the world to say something nice about you, that is a warning sign. If three people will say good things about you, that doesn't mean that you're going to be a good employee. The public doesn't understand this distinction, and doesn't know which journals have any respect within the field. So regulated industries have dutifully gone and created journals that will say whatever they're paid to say -- just as the creationists have done. The news reports then compile, say, a "list of scientists opposing the mainstream scientific assessment of global warming" as though scientific consensus were decided by majority vote among equals.
If there's the slightest bit of doubt about, say, the cause of a disease, industry pounces and insists that more research is necessary. More research will always be necessary: science never attains the truth, only better and better approximations to the truth. The situation is complicated in public health by scientists' inability to conduct controlled experiments: it is immoral to subject patients to a potentially crippling disease. So scientists are forced to make educated guesses: this population -- of popcorn-factory workers, say -- has probably been subjected to thus-and-such a daily dosage of diacetyl for thus-and-so many years, whereas this other group of workers in the same factory has had less exposure. Meanwhile, people living near the factory but not working in it almost never experience popcorn lung. Hence we make the educated guess that the additional cases of bronchiolitis obliterans are due to diacetyl exposure within the factory.
Having reached a tentative conclusion about what's making people sick, we have some options. We can mandate that factories use a different chemical. Does industry have other, safer alternatives? Presumably it does, but those alternatives are more expensive; otherwise it would already be using them. If industry were forced to use safer alternatives, would economies of scale drive the price down to the point that consumers wouldn't notice?
That approach seems ethically sterile to me. It seems better to start with the assumption that no one should get sick at work. Being ethical about this means, in many cases, taking Paul Farmer's "preferential option for the poor" seriously. You'd probably find that most people getting sick at work are not wealthy; hedge-fund managers and computer scientists aren't coming into daily contact with beryllium; even if they are, wealthier folks can insist on workplace-safety measures in a way that the poor cannot. I'd wager that workplace safety is another front in the fight for distributive justice.
Michaels is a former Department of Energy official whose work centered on the safety of nuclear plants. As such, he has a somewhat reflexive faith in the power of regulation. To me it rang hollow: one regulation will limit diacetyl, another will limit beryllium, another will prevent factory workers from acquiring repetitive-strain disorders -- but will any real problems be solved? Companies' desire and ability to game the system is virtually limitless. When they lose the regulatory war, they invent a public-relations campaign to convince Americans that tort reform is necessary. They demonize "trial lawyers" (lawyers who write briefs and stay out of the courtroom are off the hook, as are lawyers who resolve cases before they reach the court). They challenge the very epistemology of the scientific revolution. If worse comes to worst, they move production of noxious chemicals to countries with lower environmental and health standards.
What I'm getting at is that we have a much more systemic problem on our hands. I applaud regulation where it helps, but I do wonder if it's tinkering at the edges of a massive problem that lies at the heart of our society. We need regulation; we also need education to explain to Americans what science is. We need Americans to believe that we owe much to the least fortunate among us. Until that message gets through, we'll have to content ourselves with putting out little brushfires while the forest burns.Doubt is Their Product: How Industry's Assault on Science Threatens Your Health Overview

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