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By Erin Sherbert
In the eyes of Clapp and LaDou, it was the occupational medicine field's equivalent of a Rosetta stone.
"There were tens of thousands of deaths. It was the largest mortality file ever found in an industry," LaDou says. "When Dr. Clapp was asked to do an analysis of the data, he found a number of instances where cancer risk was increased in IBM employees. There have previously been some very small cancer studies of marginal significance because of their size.
"But here the data bank was so large that any increase was significant. Here was something you could really get your teeth into. When you correlated that to the exposure data, we would have a real epidemiology to publish."
Where medical researchers saw a data trove, IBM apparently saw an enormous potential liability. The company's lawyers are reported to have called Clapp's study litigation-driven junk science, and last October a California Superior Court judge ruled that the study wasn't admissible in the lawsuit that had spawned it because the study didn't specifically link increased cancer risk to chemical exposure.
LaDou says the study could not link increased mortality to chemicals because IBM wouldn't reveal the job assignments of employees who'd died of cancer. "He [Clapp] had a limited study, because he had limited information," LaDou says. "He did not have work-assignment data. He did not have the years of exposure to chemicals. His findings were still cause for alarm."
Last month several of the San Jose plaintiffs received settlements under secret terms. But more than 100 similar cases are still pending against IBM around the country.
I got an automated out-of-office message when I e-mailed a series of questions about the controversy to Elsevier spokesperson Marike Westra. But in June, Westra told The Scientist magazine that the Clapp paper was rejected because it was an original work, and Clinics only publishes review papers discussing research conducted by other scientists.
Hogwash, LaDou says.
"In their instructions to me as a guest editor, I was not told that," LaDou told me. "When I presented the article as part of our original list of papers, no one said that. And looking back over other issues of this same journal, I see other original research articles in them. Which leads me to the conclusion that this was a convenient excuse not to publish the paper because they didn't want to run afoul of a major corporation."
As for supposed pressure from IBM, Westra told The Scientistthat the electronics giant did not ask Elsevier to block publication.
LaDou, however, suggests that the Clinics flap is only the latest in a series of censorship disputes involving Elsevier. He sent me the October-December 2003 issue of the International Journal of Occupational Environmental Health containing an exchange of letters in which 40 scientists accused another Elsevier journal, Regulatory Toxicology and Pharmacology, of "corporate conflicts of interest, lack of transparency, and absence of editorial independence." The scientists also contended that the journal "serves as a convenient venue for the publication of industry research."
The journal had published papers paid for by the tobacco industry without revealing this sponsorship and had published numerous other papers by paid consultants for various industries without revealing those links, the letters contended.
The editor of Occupational Environmental Health wrote that the letters were published in order to "alert readers to the ways in which supposedly credible peer-reviewed journals may be co-opted by corporations to give credibility to particular scientific points of view."
Elsevier responded by disputing some of the scientists' points, yet announcing it would institute a policy that would request that authors "disclose any possible conflicts of interest."
Once it became clear that Clinics in Occupational and Environmental Medicinewould not publish Clapp's study, 13 other scientists withheld their studies from the special issue on the electronics industry.
Robert Harrison, a UCSF professor who had intended to contribute a paper studying blood tests performed on people exposed to chemicals of the types used at companies such as IBM, says information in the censored Clinics paper is crucial to diagnosing and treating cancer patients who might have been electronics industry workers.
"We agreed to withhold our papers because disseminating information to our colleagues, and how you diagnose and treat and prevent these illnesses, is really important. We're sending the message that that principle needs to be maintained," Harrison says. "I think it's important that a group of scientists and physicians are standing together to make a statement."
Clapp, the scientist whose paper was rejected by the Clinics publisher, says the importance of his study, and the boycott, transcends academia. "This study of health in the semiconductor industry is a big issue in the Bay Area. I think the results of the study should be public. It's a way people can protect themselves," Clapp says. "There are chemicals [that] people are working with that can cause cancer, and that's information that's important. That's what the bottom line is: It's people being able to protect themselves and their families."
The story of the Clinics in Occupational and Environmental Medicine13 appears to have a happy ending. Clapp says he's determined that his information be made available to the public, despite IBM's efforts in a New York lawsuit to keep the information out of court in the San Jose case.