The John Graham Nomination: Public Citizens Rebuttal
to "Who Is Professor John D. Graham?
A Scholarly Response to Public Citizen"
In an April 25, 2001 letter to the Senate Governmental Affairs Committee, a small group of Grahams students and colleagues at the Harvard Center for Risk Analysis, which he directs, attempted to rebut charges made against Graham by Public Citizen in its report: "Safeguards at Risk: John Graham and Corporate Americas Back Door to the Bush White House."
Below is Public Citizens response to their letter. A centerpiece of their response is that Graham and HCRA were so independent of their funders that there have been at least 10 instances "where HCRA and Graham have used data and analysis in constructive ways that are contrary to the interests of HCRAs industrial sponsors."
All the Authors Are Current or Former Employees or Students of Grahams
The seven listed authors, who describe themselves as Professors at the Harvard School of Public Health, are all on the faculty of the Harvard Center for Risk Analysis (HCRA), which John Graham founded and led for the past 10 years. Only two of the nine members of the HCRA faculty are not listed as authors. This fact should have been disclosed.
HCRAs Conflict-of-Interest Policy Does Not Ensure Objective, Scientific Work
All the attention paid to HCRAs policies for dealing with restricted grants misses the point. It is true that the peer review procedures that often accompany projects directly commissioned by restricted government or industry funding inject some amount of objectivity into the process. The amount of objectivity depends upon the rigor of the peer review for example, HCRAs "internal peer review" has been aptly described as an abuse of the term "peer review" because the review is conducted only by colleagues at HCRA rather than by objective, independent reviewers without any proprietary interest in the outcome of a study or content of a newsletter.
However, 40 percent of HCRAs funding comes from unrestricted money entirely from corporate contributors, such as the American Automobile Manufacturers Association, American Crop Protection Association, American Petroleum Institute, Chemical Manufacturers Association, Chlorine Chemistry Council, Dow Chemical, ExxonMobil, Monsanto and International Paper. This funding does not necessarily go towards scholarly or scientific work. Much of it goes to produce short "policy pieces" and media work, intended to influence decision makers, the media and the general public. These "think tank" activities at HCRA are similar to activities undertaken by entities such as the CATO Institute and the Heritage Foundation.
The Letter from HCRA Fails to Answer Grahams Critics
In opposing Grahams nomination, Public Citizens critique has been that, in general, Graham tends not to bite the hand that feeds him: If a specific corporation funds a study, that studys conclusions are favorable to the benefactor. None of the points in the letter from the Center disproves this central contention.
Overall, Grahams Work Is Anti-Regulation and Pro-Industry
Graham presented 125 published articles and reports to the Senate Governmental Affairs Committee. The fact that the letter from his Center can point to a mere 10 examples of his or his Centers alleged independence from industry is not particularly impressive. This number appears particularly small when one considers that many of the examples actually focus on the work of Grahams colleagues and students, rather than on Graham himself. As the letter includes references to the work of Grahams students, both past and present, and present HCRA faculty members, the ten examples is an extremely small number in comparison to the amount of research that the Center evidently deemed was eligible for inclusion in the letter.
The Centers Ample Use of Unrestricted Funds Is Used to Hide the Ball
Many of Grahams studies are funded by unrestricted funds. Because the public has no idea whose money is being used to fund any given study, the impact of this funding is difficult to assess. In this respect, the unrestricted funding arrangement is subject to greater corporate influence than studies funded by just one corporate donor, and provides far greater benefits to corporations that may wish to smudge the line connecting their funding with a particular result.
Most research scientists refuse to accept unrestricted funding precisely because it can taint the integrity of all of their research. In fact, most academic scientists scrupulously avoid any financial conflicts of interest since the integrity of their reputation is far too important to imperil. Yet documents from the Phillip Morris litigation archives show that Graham aggressively pursued unrestricted funds in his fundraising solicitations, a most unusual step. Rather than seizing the opportunity to reveal additional information about the Centers funding levels and to clear the record, the letter from the Center offers only vague allegations that several of Grahams positions may be somewhat inconsistent with the interests of some sub-groups of Grahams funders. This is far from the level of disclosure needed for a meaningful rebuttal.
The Centers Answers Fail to Explain the Strategic Context for Arguments, Which Is Key
In the 10 examples of Grahams pro-regulatory position outlined in the rebuttal, it is often the case that Grahams suggestion only appears to be safety or health-oriented. Knowing the political context of such suggestions is critical. If an industry believes that a change in its position is necessary to prevent the enactment of more demanding health or safety measures, it will often attempt to deflect attention from the real issues by arguing that unimportant "distractor" issues must be addressed first or by occupying a false "middle ground." For example, Grahams suggestion that non-cancer risks of dioxin should be the focus of additional research appears public-spirited until we recall that his statement occurred at the same meeting of the dioxin Science Advisory Board in which he urged dioxin to be classified as an "anti-carcinogen." In sum, strategic deflection of issues or a research agenda is a common industry ruse to distract regulators and the public from acting on the risks that we do know about.
Public Citizens Response to 10 Examples in the
Letter from HCRA Faculty
Below are specific answers regarding the rebuttal letters list of 10 issues in which Graham allegedly has acted against the best interests of his funders and in the interest of public health. In each case, the claims made by Grahams supporters are insufficient to demonstrate that Graham is truly dedicated to regulatory solutions that enhance health, safety or the environment.
(1) Indoor Air Pollution
The letter from HCRA claims that Graham has been a leader in identifying indoor air pollution as a hazard. In Grahams 1999 testimony to the Senate cited in the letter, however, Graham was very critical of the Clean Air Act, which he claimed revealed an undue focus on outdoor air as opposed to indoor air. Of course, deflecting attention away from outdoor air pollution issues and the need for the Clean Air Act could serve his funders financial and regulatory interests in many ways. Compliance with the dictates of the Clean Air Act has proved expensive for industry, so much so that they recently fought it all the way to the Supreme Court. Like industry, Graham has argued against the Act. Graham signed onto a brief with other economists submitted in the Clean Air Act case, suggesting that the weight of the economic arguments were on the side of the trucking industry and against the Act.
In addition, indoor air quality, unlike outdoor air, concerns issues such as radon, which Graham mentioned as a "neglected" area in his testimony, for which responsibility is diffuse and may belong to individual landowners rather than large corporations.
(2) Non-Cancer Risks of Dioxin
No one can disagree that additional research on the non-cancer effects of many chemicals, including dioxin, is sorely needed. Grahams support for such research indicates little more than that he assents to a widely-held belief that it is warranted.
Cancer is one of the few biological health effects for which we currently have good dose-response data, thus enabling us to regulate exposure levels based on the cancer risk. Because good data on the cause of other diseases and illnesses is so hard to produce, however, Grahams suggestion that non-cancer data should be developed may result in much unnecessary delay, if such data is required as a predicate to regulatory standards.
At the same meetings of the dioxin risk assessment Science Advisory Board that Graham raised the issue of dioxins non-cancer effects, he also suggested that EPA label dioxin a "possible anti-carcinogen," a suggestion justified by reference to only two, outlying studies of the toxic chemical. Dioxin is widely recognized as a dangerous chemical, and was an ingredient in the chemical used in Vietnam known as Agent Orange. An April 18, 2000 memorandum from Dr. William Farland, Acting Deputy Assistant Administrator for Science at the EPA, admonished the Dioxin Reassessment Review Committee for the poor quality of its work. In the memo, Dr. Farland specifically addresses Grahams assertions about dioxin being a possible anti-carcinogen, stating "[t]he promulgation of [Grahams] hypothesis is irresponsible and inaccurate."
Given this context, it appears that Grahams suggestion that non-cancer effects, which are notoriously difficult to measure, receive an increased research focus may have been yet another stalling tactic in the service of his funders. At least 47 HCRA funders have been identified as dioxin producers by the Center for Health and Environmental Justice. Certainly, it is far from clear that Grahams support of such studies would have any negative impact upon the regulatory environment for his funders, and it may have actually assisted them by implying that further scientific work is needed to justify a rule on dioxin.
(3) Default Cancer Potency Numbers
The letter from HCRA relies here upon the work of a doctoral student of Grahams. We believe the work of a graduate student of the Harvard School of Public Health is well beyond the appropriate scope of the inquiry for Grahams nomination to OMB. More importantly, the letter from HCRA fails to establish how Grahams suggestion regarding default cancer potency numbers is in any tension with the interests of his funders, or to identify which funders would be impacted by his proposal. This renders their assertions difficult to rebut.
The presence of unrestricted funding makes it difficult to draw a line between any one of Grahams policy proposals and their origin. However, when observers are able to trace the funding, and a specific corporation or industry group has allotted restricted funding for a HCRA study related to the carcinogenic effects of chemicals and pollutants, the studys conclusions frequently mirror the positions of the funder, downplaying probable cancer-related outcomes and reflecting an interpretation of the data that is questionable from a scientific perspective.
For example, in 1999, HCRA released a study paid for by the American Farm Bureau Federation that concluded that banning certain older, highly toxic pesticides under the Food Quality Protection Act would actually increase the loss of life because of disruptions to the food supply. The conclusion relied upon the completely unrealistic assumptions that the restrictions would cause a catastrophic shortage of insecticides available to farmers and that the readily available alternative chemical and non-chemical pest control options would not be used as replacements. HCRA selected indefensible assumptions to reach a conclusion favorable to the Farm Bureau, its funder.
Another example is the research done by HCRA on diesel truck emissions for a restricted funding contract. Graham co-authored a January 2000 HCRA report that compared air pollution from diesel and natural gas heavy trucks. Graham's use of problematic assumptions led him to suggest that heavy-duty trucks with diesel engines may actually pose a lesser ultra-fine particulate risk than those fueled by natural gas. The report's conclusions echoed the position of Navistar, the company that paid for the research. Navistar is one of the few diesel engine manufacturers that does not also make natural gas engines.
Graham reached his conclusions largely by suggesting that natural gas engines produced more ultra-fine particulates that pose a serious health risk. Yet the science is totally inconclusive on this issue. According to the Department of Energy labs, scientists cannot even agree on the proper method to sample and measure these small particles, nor are there any guidelines on what levels are harmful. In the study, Graham also claimed that little was known about the comparative carcinogenicity of the particulates produced by the two engine types. This claim is untenable. Independent experts confirm that natural gas exhaust has very low toxicity, while diesel exhaust contains more than forty toxic chemicals, about half of which are known or suspected carcinogens.
The letter from HCRA suggests that Grahams statements that he "sees a role for consideration of equity and intangible factors" in regulatory decision making demonstrates his independence from HCRA's industrial sponsors. Claiming to be sensitive on such matters is widely viewed as a prerequisite to any intelligent policy exchange such claims show little but that Graham is prepared to give lip service to basic notions of fairness and distributional justice. However, the record shows that Grahams recommendations would actually devalue these types of considerations and privilege economic factors instead. The changes advocated by Graham in his testimony on so-called "regulatory reform" legislation would decrease OMBs and agencies consideration of equity and intangible concerns in regulatory policy. By consistently advocating that the federal government give greater weight to those regulatory priorities that are economically cost-beneficial, Graham has promoted a shift of priorities away from other important concerns. When a decision maker gives more weight to the results of economic, cost-benefit analysis, less weight is necessarily given to non-economic concerns such as equity and intangible factors.
- A Role for "Equity" and "Intangibles"
Graham claims that he should be distinguished because he does not favor what is called "strict" cost-benefit analysis, and would allow "intangible" factors that are not easily rendered in monetary values to provide a basis for a regulatory decision, if a regulatory agency can plead its case in a way that makes the reason for its decision clear. This is a partial and somewhat begrudging solution. Graham fails to explain how an agency could makes it case, and why the agency should be required by OMB to re-justify an action that a Congressional mandate and the democratic process has already more than fully authorized.The letter from HCRA provides a few examples in which Graham has allegedly examined equitable concerns. But a closer examination of the examples provided in the rebuttal shows that Grahams research might not have any negative consequences for industry. For example, although Graham co-authored a study that found that census tracts near coke plants have a disproportionate share of poor and nonwhite residents, he did not propose or support a solution of any kind to this problem of environmental injustice. In fact, the conclusions of that study did not even suggest a role for environmental equity in regulatory decision-making.
In another article, Graham suggested that it might be a good idea to allow an oil refinery to avoid remediating toxic air pollution if that company funded AIDS-prevention or violence-prevention programs. When asked during a Senate committee hearing how this proposal would "help the family who lived next door to the refinery," Graham had to admit that someone could legitimately make equity objections against that kind of trade.
(5) Gasoline Taxes and Consumer Tax Credits for Energy Consumption
Grahams position on this issue is no different from the automotive industrys. Because of Grahams acceptance of unrestricted funding from both the auto industry and from oil and gas clients, we may never know which group is his largest donor. Therefore, it is impossible to say whether Grahams position on the issue is in fact in opposition to his true financial interests.
What is clear is that raising gasoline taxes has been the mantra of the auto industry for years, as a bargained-for substitute to more stringent fuel economy regulations. For both the industry and Graham, the notion of increasing gas taxes is a fail-safe argument in the attempt to defer new fuel economy (CAFÉ) standards. As both Graham and the industry are well aware, it is politically impossible to raise gasoline taxes to the level at which they would actually deter gasoline consumption.
Studies show that the increase in price that would be required to reduce consumption to environmentally acceptable levels would be in the range of $3 per gallon. In addition, this would put the burden of changing environmental behavior squarely on the consumer, rather than on the industry, which in fact technologically controls the rate of fuel consumption in cars. The argument on gas taxes is a non-starter, a fact that should discourage any policy-minded advocate from pointing to it as evidence of his or her open-mindedness.
Grahams other allegedly pro-regulation proposal is also a half-way measure that would accomplish very little. As consumer advocates have long argued, consumer tax credits for more efficient vehicles are a valid option only if they are accompanied by stronger fuel efficiency standards overall, because their impact on the overall vehicle fleet would be very minimal, both at first and for the foreseeable future.
Grahams tax credit suggestion also parrots the position of the auto industry, for the obvious reason that it would create a federal subsidy to do on a limited basis what the auto industry should do to improve fuel economy overall. Without performance standards that apply to every new car, the result could be a rush for hybrid vehicles that bankrupts the federal treasury and fails to change the overall level of vehicle emissions, as in Arizonas recent experiment with tax credits for hybrid vehicles, in which unexpectedly high consumer demand for the vehicles bankrupted the allotted money in short order.
(6) Outdoor Particulate Air Pollution
The letter from Grahams Center points to the work of Dr. John Evans and two doctoral students as evidence that Graham generally recognizes the need to regulate outdoor particulate air pollution. Yet Graham joined Evans and one of these students in producing a report that questioned the estimated benefits of EPAs 1997 standard for particulate matter because many of the lives saved would be older people.
His report contends that EPA overestimated the benefits of the regulation by basing its estimates on healthy, middle-aged workers because "most acute air pollution deaths occur among elderly persons with serious preexisting cardiac and respiratory disease." The authors suggest that the benefits of the regulation would be substantially smaller than EPAs estimate because the probable victims of air pollution, the elderly, have fewer years to live and declining health. Thus, Graham essentially argues that the old and sick are less worthy of protection from particulates because their lives are of less value.
The rebuttal from the Center claims that Grahams position is that particulate matter "should be regulated under a cost-benefit framework." Since this is a much less protective framework than exists under current law, which mandates that standards must allow for an "adequate margin of safety to protect the public health," we cannot see how this refutes Public Citizens claim that HCRAs work generally favors its industry sponsors. The document also states that Graham thinks the case for stricter ozone rules "is much weaker." This position also favors HCRAs numerous industry sponsors, many of whom are very opposed to stricter EPA ozone rules.
(7) Global Warming
Grahams support of a graduate student concentrating on climate change should be deemed irrelevant to his personal qualifications for a position at OMB or to his personal integrity as a researcher.
Graham joins a corporate and Bush Administration consensus in opposing the Kyoto Protocol, which commits developed countries to only moderate reductions in greenhouse gas emissions. Since Graham is unwilling to support Kyoto, it is difficult to understand how he expects the U.S. to take a leadership role on global climate change, as his supporters claim.
Graham does support "long-term," "modest" and "cost-effective" steps to "demonstrate our countrys seriousness" and "spur global policies." Grahams view of global warming is consistent with the position on climate change issues shared by many, if not most, of his corporate funders. Again, HCRAs disclosure of funding levels is so incomplete that it is impossible to tell whether the most generous funders play a role in determining his support of various proposals. Yet basic research failed to substantiate the Centers claim that his funders generally adopt a "just say no" approach to global climate change. In some cases, Grahams rhetoric appears to be even more conservative than the public positions of the oil and gas interests that have funded his work.
Chevron Research and Technology Company is an unrestricted funder of Graham. The Chevron Web site recognizes the problem of global warming and states that the company supports international mechanisms to address the proliferation of greenhouse gases and "incentives to reduce greenhouse gas emissions."
Exxon and Mobil are listed as unrestricted supporters of Graham. ExxonMobils position paper on global warming, at www.exxonmobil.com, indicates that the company recognizes that climate change is a "long-term" risk, articulates its understanding that the Kyoto protocol is a "mistake" and supports voluntary corporate action, international technology transfer, and additional research on energy alternatives.
Texaco is listed as an unrestricted HCRA funder. A letter to Greenpeace on the Texaco Web site states its opposition to the targets set by the Kyoto Protocol but qualifies that opposition considerably with a recognition of the importance of the issue: "Texaco certainly takes the issue of climate change seriously and is committed to playing a constructive role in finding solutions to the challenge of global climate change."
DuPont Agricultural Products is listed as an unrestricted HCRA funder. DuPonts Web site claims, sounding very much like Graham, that the company views the Kyoto Protocol as "an expression by governments of the seriousness with which they view climate change." In the statement, DuPont, like Graham, questions the efficacy of some portions of the Protocol, yet also, like Graham, endorses the need for some action by the company to reduce greenhouse gases.
Once again, Grahams supporters argue his moderation with only the slimmest of evidence, and suggest that Graham should be viewed as possessing integrity only because he does not hold the most extreme of all possible points of view.
(8) Regulation of Sport-Utility Vehicles (SUVs)
Due to the media attention to the Ford-Firestone tragedy, the safety of SUVs has finally come under the scrutiny that is warranted. Yet the article by Graham on SUVs that is cited in the letter from HCRA demonstrates far more concern with salvaging the tattered reputation of SUVs than with consumer safety. Grahams article of March 2001 may properly be considered an apologia for the SUV, or, alternatively, a to-do list for auto manufacturers that hope to save SUVs from the scrap heap.
For example, Grahams solution for the dangerous tendencies of SUVs to crush other vehicles in a crash is to add a shocking 900 pounds to the weight of smaller cars a bizarre proposal that would have U.S. drivers consume huge amounts of steel and petroleum resources to decrease their risk of a fatal collision with an SUV.
In the article, which drew approving letters from Ford Motor Company and the Competitive Enterprise Institute, Graham suggests that purchasers of small cars "need to be informed of the adverse safety implications of their choice." The reason small cars are so dangerous? Because of the aggressiveness, or "aggressivity," of SUVs in crashes with small cars. Yet Graham does not propose that SUV owners should be treated to any similar warnings about the lethal impact of SUVs in crashes with cars. In contrast, the General Accounting Office, in a major study of SUV aggressivity, has proposed that SUV vehicle weight be reduced to have less impact on passenger cars in a crash.
Grahams article calls any federal program that would "discourage" consumers from purchasing SUVs an "extreme position." While Graham mentions that much higher fuel economy standards have enabled the growth of SUVs as a class, his solution is not to expect SUVs to match the fuel economy of cars. Instead, he suggests that station wagons, a virtually extinct type of vehicle, be re-classified as trucks, thus enabling manufacturers to meet average fuel economy targets without actually altering the obscenely-high fuel economy standards for SUVs by creating a manufacturers "incentive to promote wagons more aggressively." He also calls for a national study of visibility problems pertaining to SUVs, a matter that is obvious to anyone who has driven on the road behind that type of vehicle.
In another delaying tactic, Graham states that "a concerted research program is needed to determine the causes and solutions of the rollover problem in SUVs and pickup trucks." He omits to mention that the National Highway Traffic Safety Administration (NHTSA) has been studying the rollover issue and its relationship to SUVs for over two decades, and has long identified the cause of rollover. Graham predicts that NHTSA will be unable to craft an "experimental" and "validate[d]" dynamic rollover test within the two-year timetable required by last falls Transportation, Recall Enhancement, Accountability and Documentation Act, thus setting the stage for industry arguments that any test developed by NHTSA within that time would be invalid, and misleadingly suggesting that dynamic rollover testing has not been amply developed and substantiated through testing over the past decade.
Graham also claims that Congress has "not done enough" to call attention to driver behavior in causing rollover crashes. Blaming the victim is a time-honored industry tactic. Graham fails to mention that much of the rollover problem is caused by the lack of information given to consumers about the differences in the handling of passenger cars and SUVs. While SUVs are marketed to take the place of passenger cars, in emergency maneuvers they handle like trucks and are much more likely to roll over, regardless of driver skill, attitude or attentiveness.
(9) Student Work on Cost-Effective Measures for "Disease"
We believe that the Centers support of graduate students should be deemed irrelevant to Grahams professional qualifications for a position at OMB or his integrity as a researcher. The letter implies that the availability of unrestricted funding is somehow "an insurance policy" that is necessary for the hiring and support of these students, yet science and research programs at most universities are funded by restricted grants that also permit the hiring of research assistants and students. We therefore fail to see the relevance of this kind of money to Grahams ability to hire students and faculty.
We cannot emphasize enough that an arrangement that depends upon unrestricted corporate funding for "scientific" research is highly unusual, because research scientists typically accept corporate money only for particular projects, and the terms of their acceptance are set out far in advance according to detailed research and funding contracts. Arguably, to depend upon no-strings-attached deals from industry may in fact be precisely the wrong way for them to begin their careers.
Although we are reluctant to enlarge the debate to include others at the Center, the faculty have themselves put the issue on the table as authors of the "scholarly response." We will limit our discussion to the work of one colleague of Grahams, Dr. Kimberly Taylor Thompson.
Dr. Thompsons work on child safety issues turns out to mirror many of Grahams own approaches, as it emphasizes "market-based" solutions and "voluntary" standards, which are a favorite of industries generally, and of the child safety market in particular. But in a recent book, Its No Accident, journalist Marla Felcher details the failure of the Consumer Product Safety Commission (CPSC) to protect infants and children from harmful and even deadly products, suggesting that the agencys "voluntary standards" approach, as promoted by industry, is actually far from adequate.
Recently, Dr. Thompson has been outspoken on the issues of regulation of baby bath seats, which have resulted in the deaths of at least 78 babies. Consumer advocates argue that the bath seats encourage parents to leave children unattended in the bath, leading to unintentional drownings of infants. According to an article this spring by Julian Barnes in the New York Times, a report by the CPSC staff recently recommended that the commission begin the process of regulating the bath seats because the risk of death for children aged 5 to 7 months is greater than bathing without the seat. But this spring, while the CPSC was considering a petition to ban the bath seats, Ms. Thompson wrote a letter to the commission arguing that the governments data did not, in fact, support a ban on bath seats.
Dr. Thompsons position is the opposite of that taken by consumer advocacy groups that are involved in the issue. The Consumer Federation of America has argued that the seats are dangerous and should be banned. Mary Ellen Fise told the Times, "Were not excusing the lack of supervision . . . But the product is leading people to take risks they would not ordinarily take." Fises comments suggest that a sensitive risk assessment, in this case, would take account of the foreseeable interaction between parents and a potentially dangerous product, in favor of a ban. Since Thompson wrote in opposition to the petition, however, the CPSC has agreed to consider the petition supporting issuance of a ban.
Dr. Thompsons largest project to date is to craft guidelines for consumers to use in a "skeptical" assessment of health risk information, including so-called "junk science." (See http://www.health-insight.harvard.edu) Her approach to the project is very similar to Grahams attitude, captured in his repetition of the idea that consumers are subject to a "syndrome of paranoia and neglect" about health risks. In Grahams work, at least, consumers over-reaction to health risks, such as Superfund sites, pesticides in food, or Alar on apples, is the problem, rather than the corporate interests that are guilty of pollution or chemical overuse.
Such claims lay the groundwork for Grahams argument in the regulatory context that the federal government is over-responsive to health "scares" and therefore emphasizes the wrong priorities in its regulatory programs. In the same vein, Dr. Thompsons year 2000 report on her project labels "speculative" and "minor" such risks for children as pesticide residue on foods, bisphenol-A in baby bottles and phthalates in childrens toys, suggesting that media stories on these so-called "health scares" contained the "theme that any risk is unacceptable for children . . . Consumers should consider the magnitude of the risks and the available alternatives before reacting to a scare." Dr. Thompson continued with a corporate defense: "[U]nwarranted product attacks hurt us all by spreading fear and wasting resources."
Dr. Thompson has also followed Grahams lead in her dependence upon corporate sponsorship. According to the October 1999 issue of the Centers Risk in Perspective newsletter, Dr. Thompsons project, known as "Health Insight," is funded by money from the Chlorine Chemistry Council (CCC), a chemical industry trade association. The CCC would have a direct stake in the public response to issues such as the leakage of potentially harmful plastics into childrens bodies when they put products, such as teething aids, containing phthalates into their mouths. While the matter of funding is acknowledged, Dr. Thompson does not acknowledge anywhere in the newsletter that the funders of the project have a direct financial stake in the issues being discussed.
If Grahams use of unrestricted funds merely supports students or faculty, such as Dr. Thompson, who argue against the need for common-sense regulatory protections that may be costly for industry, there appears to be little conflict between the Centers research agenda and the interests of its corporate funders.
(10) Air Bags
Grahams supporters fail to mention or to refute the allegations contained in the Public Citizen report on Graham, which included an entire case study concerning Grahams work on the air bags issue. As we document, prior to the completion or publication of a study on passenger side air bags cost-effectiveness, Graham went on national television and before the National Transportation Safety Board to announce that his research had demonstrated that passenger side air bags cost an unreasonably high $399,000 for each year of life they saved.
Following loud agitation by consumer advocates, Grahams study was peer reviewed. When it was finally published in the Journal of the American Medical Association, the conclusion was transformed. Passenger side air bags, the study now concluded, cost a mere $60,000 for every life-year saved and therefore were considered cost-effective.
At the Governmental Affairs Committee hearing for his nomination, letters in support of Graham were read into the record to suggest that the change in Grahams conclusion actually flowed from his lack of bias on the issue. Yet the original problem remains, which is that Grahams announcement of his results was disturbingly premature. Given his acceptance of unrestricted funding from major players in the automotive industry, Grahams opportunistic actions before the NTSB and media speak far louder than his later revision, under protest, of his peer-reviewed results.
The letter from the Center fails to demonstrate how any of Grahams conclusions on the air bag issue are in tension with the objectives of his industry funders. Even without that information, his bias is possible to discern.
The analysis presented in the letter from the Center overlooks some of the key issues in air bag research. One prominent problem is that Graham appears to assume that all makes and models of air bags present an identical or similar risk to children and small-statured adults. This assumption favors automobile manufacturers, because it would set safety standards at the average safety level, rather than rewarding those manufacturers that have developed superior (and sometimes more costly) air bag technology. A regulator interested in the safety levels that can feasibly be achieved would be more interested in discovering the varied rates of injury and fatality among air bag types. For example, Hondas air bags, which deploy into the windshield before impacting occupants, have caused no fatalities to date.
At the bottom of p. 11, the letter from the Center suggests that Graham favors the equivalent of an automatic air bag on/off switch. His version of advanced air bag technology is simplistic and replicates an industry position used to deflect more sophisticated, and potentially more costly, air bag requirements. For example, air bag sensing technology exists that would detect an out-of-position occupant or child, and would adjust the level of deployment according to that information as well as the severity of the crash. This is a much more safety-oriented solution than is Grahams proposal, because it would protect occupants and children in a far wider range of crash scenarios.
In addition, Grahams overall conclusions for air bag policy, as presented in the letter from HCRA, systematically privilege cost-effectiveness considerations over the public health implications of air bags, in a manner consistent with the emphasis we have criticized in the rest of his body of work.
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