Are we ever sure of anything? How do we know that some chemical causes cancer? Do we really know what causes a back injury? 

Creating doubt about what we know – at least enough to derail government regulation – is an art long practiced and highly perfected by some sectors of private industry. 

In an impressive new book, Doubt is Their Product, George Washington University Professor Dr. David Michaels vividly demonstrates how industry channels some of its profit to “product defense firms” and self-interested scientists who conduct research designed to cast doubt on the science that supports regulation. By outspending occupational and public health advocates, industry outguns them as well, creating an impression in the public’s mind that research results are questionable at best. As a result, regulation to protect the health and safety of the public and workers is delayed, sometimes for decades, and thousands of people unnecessarily suffer or die. 

Michaels, who was the head of occupational safety and health in President Clinton’s Department of Energy, goes through chapter after chapter of examples showing how industries stack the deck against regulation of their products. From the tobacco, lead and asbestos industry cover ups to the Vioxx debacle and global warming, from chromium to beryllium and popcorn lung, industry follows a familiar pattern. Taking studies that concluded their products are hazardous, industry schemers contract with their own stable of dependable scientists to reanalyze the data, dilute the effects and conclude that it is doubtful that the product is as risky as it may have first seemed. Showing how the Congress, the courts and the Administration intervene with industry to throw even more road blocks into the paths of regulators, Michaels paints a very cogent and impassioned picture of the current sad state of affairs wherein few, if any, new regulations are issued and existing regulations become hopelessly out of date. 

Michaels takes his title from a cigarette executive who said, “Doubt…is the best means of competing with the ‘body of fact’ that exists in the mind of the general public. It is also the means of establishing a controversy.” In case after case, Michaels illustrates how industries twist the truth enough to make everyone a little less certain, just enough to conclude that regulation is unwarranted. A decade later, perhaps, the truth becomes undeniable and regulations proceed, but meanwhile, thousands of consumers and workers have been harmed while company profits have been sustained. 

None of this is very surprising and many of these stories have been published before in scientific journals and the news media. But pulling them all together in this book is a great service because it shows the pattern of confusing facts by design and for profit. While most of the book focuses on chemical hazards (and drugs), I was glad to see a few pages discussing the “controversy” over sprain and strain injuries because industry has employed the same tactics and methodology to deflect ergonomic regulation.   In the final 30 pages of the book, Michaels lays out a variety of prescriptions for this debacle. 

First, he presses for judicial reform to make the courts recognize the way science truly operates and quit demanding certainty where it does not, and cannot, exist. 

Then, he makes a strong case for more transparency in science. Conflicts of interest should be revealed. Scientists working for the industry should be excluded from peer review and science advisory boards. All tests done by industry should be publically announced and acknowledged, and their data, regardless of their outcome and interpretation, should be publically available.   Deception or hiding data about toxic effects of products should result in criminal and civil penalties. 

Also, any “inside” industry information about potential product and workplace hazards should be made public as well. In regulating chemical hazards, Michaels argues for requiring companies to test all chemicals before they are marketed, reducing exposures “as low as reasonably achievable” and integrating environmental and occupational health. Companies should be required to have safety and health plans to address hazards in their workplaces and be required to stick to them. He suggests that state health departments and OSHA programs be given more leeway to experiment with innovative and more stringent regulatory programs.

Michaels’ recommendations are good ones and will help get the U.S. regulatory apparatus back on track. However, overcoming industry’s roadblocks will take a change of Administration, a change in Congress or both. It will also require a bigger budget. Currently, OSHA only spends about $16 million a year or about 3.5 percent of its budget on all regulatory (and guidance) efforts. No wonder it can’t get anything done!

Better regulation is only one piece of the puzzle. Though it is beyond the scope of Michael’s critique, even good, science-based regulations are not very effective if they are not fairly and consistently enforced. Despite existing regulations, over 5,800 workers are killed annually at work. In general, broader enforcement is needed to compel wider regulatory compliance, and better mechanisms need to be found to target enforcement to the worst actors. I’d also like to see Michaels’ proposals expanded to address safety as well as health hazards and to improve data collection.

Doubt is Their Product is a well-written book, a page turner, that offers a crystal clear glimpse at our ailing regulatory system and how it could be fixed. Doing so will take new political will, driven by electoral change in November. Read this book, get angry and get active.

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