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Barnes
and Bero report that while most reviews of passive smoking conclude
that it is harmful to human health, when the author has an affiliation
with the tobacoo industry, the review is more likely to reach the
opposite conclusion.
What
did they do? Barnes and Bero analyzed 106 reviews of the health
effects of passive smoking published from 1980 to 1995 for which
it was possible to determine whether one or more authors had received
funding from or participated in activities sponsored by the tobacco
industry. Articles were identified through electronic literature
searches and a database of symposia related to the topic.
Each
review article was evaluated by 2 independent assessors with no
conflict of interest in the outcome and without knowledge of the
identity or affiliation of the review authors. The assessors categorized
the article as concluding either that passive smoking is or is not
harmful. They also assessed a series of other parameters related
to the quality of the review article, its peer review staus, year
of publication, etc. These variables were all then used in a multivariate
analysis to determine which article characteristics were most closely
associated with the conclusion that passive smoking is not harmful
to health.
What
did they find? Of the 106 review articles, 29 were written by
tobacco-affiliated authors (see Table, below). Of these 29, 94%
concluded that passive smoke is not dangerous. Only 2 written by
tobacco-affiliated scientists found that passive smoking is harmful.
In contrast, of the 75 articles written by independent scientists,
87% found that passive smoke is harmful.
| |
Article
conclusion |
Tobacco-affiliated
authors
|
No
tobacco affiliation
|
|
| |
Concludes
passive smoking is harmful |
2
|
65
|
|
| |
Concludes
passive smoking not harmful |
29
|
10
|
|
The
pattern in this table is statistically highly significant (P<
.001). When an article is written by a tobacco scientist, it
is highly unlikely that the conclusions will be unfavorable to the
industry.
The
multiple regression analysis yielded a similar result. "The
odds that a review article with tobacco industry-affiliated authors
would conclude that passive smoking is not harmful were 88.4 times
higher than the odds for a review article with non-tobacco affiliated
authors, when controlling for article quality, peer review status,
article topic, and year of publication (95% CI, 16.4-476.5; P
< .001)."
What
does this mean? This is one example of a series of analyses
showing that when an author has a financial interest in the outcome
of a study, the conclusions are likely to be biased in favorof the
financial interest. There is every reason to believe that this
finding is relevant for studies of the health effects of contamination,
also. Indeed an analysis of
papers obtained through legal proceedings in tobacco suits has
revealed that the Chemical Manufacturers Association (known now
as the American Chemistry Council) participated with the tobacco
industry in co-funding a organization established explicitly
to weaken epidemiological conclusions.
The
debate over lead poisoning is a past example from the chemical industry
in which industry scientists produced consistently biased findings.
A similar case appears to be playing out currently, with multiple
independent scientists reporting many low-level effects of bisphenol
A, while industry labs report they cannot replicate the studies.
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